Original clinical scienceStress Echocardiography as a Gatekeeper to Donation in Aged Marginal Donor Hearts: Anatomic and Pathologic Correlations of Abnormal Stress Echocardiography Results
Section snippets
Marginal Donor Recruitment
This study defined a marginal candidate donor as a patient aged between 55 and 65 years, or < 55 but with concomitant risk factors, including possible cocaine use, > 2 risk factors such as hypertension, hyperlipidemia, smoking, or diabetes. From April 2005 to 2008, 18 marginal candidate donors (9 men) with a mean age of 58 ± 5 years were initially enrolled (Figure 1).
After legal declaration of brain death, all marginal donors underwent a baseline echocardiogram for evaluation of regional
Results
After legal declaration of brain death, the 18 marginal donors enrolled in the study underwent bedside transthoracic or transesophageal echocardiography. Resting echocardiography showed wall motion abnormalities in 5 hearts and they were removed from the stress echo protocol. Stress echo was performed in the remaining 13, using dipyridamole in 11, and dobutamine in 2. Seven donors had maximal stress with normal LV WMSI (rest = peak = 1), peak stress LV elastance > rest, and 6 hearts were
Discussion
Age restrictions (< 55 years) in cardiac donors are being relaxed because of limited donor supply. Close examination of the potential cardiac donor pool is necessary to understand and alleviate the shortage of these donor organs. In this preliminary pilot study, 18 marginal candidate donors were screened by pharmacologic stress echo. Five were not eligible by baseline echocardiography, and 6 that were still eligible at rest were excluded by the stress echo results. Morphopathology in aged donor
Disclosure Statement
Partial funding for this project was provided by Heart and Lung Transplantation Program, Regione Emilia–Romagna (1ASTEARP).
None of the authors has a financial interest or other potential conflict of interest related to the subject matter or materials mentioned in the manuscript.
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