Abstract 17826: Frequency and Pattern of Left Ventricular Dysfunction in Potential Heart Transplant Donors

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Cardiac transplantation is a recognized treatment for patients with end stage cardiomyopathy. However, the scarcity of donor hearts remains a limiting factor. In addition, some potential donor hearts may be rejected due to cardiac dysfunction reported on diagnostic imaging by echocardiography or cardiac catheterization. We report a series of 34 consecutive adult organ donors whose hearts were evaluated for LV systolic function. The donors suffered acute, fatal brain injury. 11/34 (32%) had LV systolic dysfunction. Predominate apical, basal, mid-cavity, or global dysfunction patterns were characterized. Serial echocardiograms, when available, were examined. The findings are summarized in the table 1. In our series we noted that serial studies uniformly demonstrated a significant improvement in LV systolic function. Improvement appeared independent of the specific pattern in LV dysfunction or sex. In 27% systolic function completely normalized. No difference between the sex of the donor and the pattern of cardiac dysfunction was seen. In conclusion, our study noted that greater than 30% of screened potential donor hearts have systolic dysfunction. A variable pattern of dysfunction is seen with Global type noted most frequently. Even in hearts with severe initial dysfunction, considerable improvement in EF occurred. Our findings suggest that an initial examination showing LV dysfunction should not exclude a potential heart donor. Reassessment over time and possibly temporizing organ procurement to permit left ventricular function to improve could increase the pool of hearts available for transplantation. Further research into the mechanism underlying transient LV dysfunction in potential heart donor suffering acute, fatal brain injury is warranted.