The Importance of Histopathological Examination for Safety in Heart Valve Transplantation – Evaluation of Histopathological Findings in Heart Tissues from Valve Donors

Abstract

Most, though not all, heart valve banks performed routine histopathological examination of heart tissues after valve donation. Histopathological examination will enhance the safety of heart valve homografts for transplantation. This is highlighted by a milestone case of cardiac sarcoidosis, a potentially fatal condition which can involve valve leaflet, in a live donor. Since then, testing is mandated for all our bank’s donors, with the objective of detecting any cardiac-related contraindications, which might be missed during donor screening. It is also a valuable tool in providing additional information about the cardiac cause of death in deceased donors, especially those who passed away suddenly or from unknown cause. A review of histopathological findings in our donors’ heart tissues revealed numerous pathological features despite the small sample size (n=50). Of the deceased donors, 62.9% were diagnosed with pathological features, among which 72.7% had multiple abnormalities. 30% of our bank’s donors were heart recipients, who had multiple cardiac abnormalities. Some pathological findings were found to be interrelated. A donor heart with cardiomegaly revealed no pathological features, emphasising the necessity to correlate pathological results with clinical data collated during donor screening for a comprehensive clinical picture in the determination of tissue suitability.