Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Rejected hearts now viable for transplantation after stress echo

05.12.2012
Pharmacological stress echo identifies donor hearts that would historically have been rejected

Hearts previously rejected due to donors' age or other risk factors can now be declared viable for transplantation using pharmacological stress echo, according to research presented at EUROECHO and other Imaging Modalities 2012. The study1 was presented by Dr Tonino Bombardini from Pisa, Italy.

EUROECHO and other Imaging Modalities 2012 is the annual meeting of the European Association of Cardiovascular Imaging (EACVI)2, a registered branch of the European Society of Cardiology (ESC)3. It takes place 5-8 December in Athens, Greece, at the Megaron Athens International Conference Centre.

Heart transplantation is an established procedure in patients with end-stage heart failure but it is limited by a severe donor organ shortage. The average age of organ donors has increased and the donor is frequently a patient who died of a stroke. Every year in Europe a pool of ˜4,500 hearts for which permission has been granted for heart donation are unused4. "Many of these hearts could be used if we could increase confidence that the transplantation would be successful," said Dr Bombardini, who is scientific coordinator of the Aged Donor Heart Rescue by Stress Echo (ADONHERS) Project.

"Currently, the use of hearts from donors = 50 years (of the total transplanted hearts) is just 21% in Europe and 12% in North America," he added. "But the lengthening of waiting lists for heart transplantation is a significant healthcare emergency and as a consequence, the criteria for acceptance of donor hearts have been expanded to include donors over the age of 55 years."5

Dr Bombardini continued: "Despite the expanded criteria, clinicians are hesitant to use hearts from older donors. The use of stress echocardiography to select hearts 'too good to die' may be a possible approach to resolving the mismatch between organ supply and demand."

During 2005 to 2012, the ADONHERS Project included 66 candidate heart donors who would previously not have been considered due to their age or other risk factors. The average age of candidate donors was 55 years. After a legal declaration of brain death, 47 donors were still considered eligible and underwent dipyridamole (n=44) or dobutamine (n=3) stress echocardiography to look for coronary artery disease or cardiomyopathy abnormalities.

The researchers found 35 hearts without heart disease that were therefore eligible for transplantation. For six of these hearts, a matching recipient could not be found and a cardiac autopsy verified the absence of significant coronary artery disease or cardiomyopathy abnormalities.

The remaining 29 eligible hearts were successfully transplanted in emergency recipients. At 1 month, 26 patients had normal heart structure and function as assessed by angiography, intravascular ultrasound, hemodynamic tests and ventriculography. Three patients had minor single vessel disease.

After a median follow up of 27 months, 26 patients had survived and 3 had died (from general sepsis, neoplasia and recurrent multiple myeloma).

Dr Bombardini said: "An upward shift of the donor age cut-off limit from the present 55 to 65 years is acceptable if a stress echocardiography screening on the candidate donor heart is normal."

He added: "Pharmacological stress echo is inexpensive and allows a simultaneous evaluation of inducible ischemia and contractile reserve of the left ventricle – therefore, it is capable of unmasking prognostically meaningful occult coronary artery disease or cardiomyopathy."

Dr Bombardini concluded: "Pharmacological stress echo is already an established technique that is used to assess and risk stratify patients with known or suspected coronary artery disease. We have shown that it can also be used to identify hearts suitable for transplantation that would previously have been unused. This requires cardiologists with experience of stress echo and ideally a second opinion from a cardiologist in a core lab (using tele-echocardiography), who can give the green light for donation."

In addition to the above research, Dr Bombardini's group will present two further abstracts on this topic at EUROECHO 20126, 7.

Notes to editor

1 Favorable short-term outcome of transplanted hearts selected from marginal donors by pharmacological stress echocardiography (abstract 50125)

2 About the European Association of Cardiovascular Imaging (EACVI)

The European Association of Cardiovascular Imaging (EACVI) is a registered branch of the ESC. Its aim is to promote excellence in clinical diagnosis, research, technical development and education in cardiovascular ultrasound and other imaging modalities in Europe. It was formerly called the European Association of Echocardiography (EAE).

3 About the European Society of Cardiology (ESC)

The European Society of Cardiology (ESC) represents more than 75,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.

4 Council of Europe, Donation and Transplantation, 2011

5 The International Society for Heart and Lung Transplantation (ISHLT) guidelines for the care of heart transplant recipients recently recommended that the use of donor hearts > 55 years should only be used if the survival benefit of heart transplantation for a recipient unequivocally exceeds the decrement in early heart transplantation survival due to transplantation of a heart with limited myocardial reserves.

6 Wait, treat and see: echocardiographic monitoring of brain-dead potential donors with stunned heart (abstract 50250)

7 Second-opinion stress tele-echocardiography for the Adonhers (aged donor heart rescue by stress echo) project (abstract 50123)

Information for journalists attending EUROECHO and other Imaging Modalities 2012

EUROECHO and other Imaging Modalities 2012 takes place during 5-8 December in Athens, Greece, at the Megaron Athens International Conference Centre. The full scientific programme is available here http://spo.escardio.org/default.aspx?eevtid=55&hit=highlight-on

Registration is possible onsite, with a valid press card, assignment letter or three bylined articles and signed Embargo form.

A press working area will be available on the exhibition lower level (Level -1). Follow the Speakers Service Centre/Press Working Area signage. There will be no press conference, but a press kit will be available and a press coordinator onsite will assist the media with any EUROECHO and other Imaging Modalities 2012 spokespersons enquiries.

Authors:

ESC Press Office
Tel: On site at Athens: +33 6 22 41 84 92
Tel: +33 (0) 4 92 94 8627
Tel: +33 (0) 4 92 94 7756
Email: press@escardio.org

ESC Press Office | EurekAlert!
Further information:
http://www.escardio.org

More articles from Health and Medicine:

nachricht New leukemia treatment offers hope
23.09.2016 | King Abdullah University of Science and Technology

nachricht Alzheimer’s: Cellular Mechanism Provides Explanation Model for Declining Memory Performance
21.09.2016 | Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: OLED microdisplays in data glasses for improved human-machine interaction

The Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP has been developing various applications for OLED microdisplays based on organic semiconductors. By integrating the capabilities of an image sensor directly into the microdisplay, eye movements can be recorded by the smart glasses and utilized for guidance and control functions, as one example. The new design will be debuted at Augmented World Expo Europe (AWE) in Berlin at Booth B25, October 18th – 19th.

“Augmented-reality” and “wearables” have become terms we encounter almost daily. Both can make daily life a little simpler and provide valuable assistance for...

Im Focus: Artificial Intelligence Helps in the Discovery of New Materials

With the help of artificial intelligence, chemists from the University of Basel in Switzerland have computed the characteristics of about two million crystals made up of four chemical elements. The researchers were able to identify 90 previously unknown thermodynamically stable crystals that can be regarded as new materials. They report on their findings in the scientific journal Physical Review Letters.

Elpasolite is a glassy, transparent, shiny and soft mineral with a cubic crystal structure. First discovered in El Paso County (Colorado, USA), it can also be...

Im Focus: Complex hardmetal tools out of the 3D printer

For the first time, Fraunhofer IKTS shows additively manufactured hardmetal tools at WorldPM 2016 in Hamburg. Mechanical, chemical as well as a high heat resistance and extreme hardness are required from tools that are used in mechanical and automotive engineering or in plastics and building materials industry. Researchers at the Fraunhofer Institute for Ceramic Technologies and Systems IKTS in Dresden managed the production of complex hardmetal tools via 3D printing in a quality that are in no way inferior to conventionally produced high-performance tools.

Fraunhofer IKTS counts decades of proven expertise in the development of hardmetals. To date, reliable cutting, drilling, pressing and stamping tools made of...

Im Focus: Launch of New Industry Working Group for Process Control in Laser Material Processing

At AKL’16, the International Laser Technology Congress held in May this year, interest in the topic of process control was greater than expected. Appropriately, the event was also used to launch the Industry Working Group for Process Control in Laser Material Processing. The group provides a forum for representatives from industry and research to initiate pre-competitive projects and discuss issues such as standards, potential cost savings and feasibility.

In the age of industry 4.0, laser technology is firmly established within manufacturing. A wide variety of laser techniques – from USP ablation and additive...

Im Focus: New laser joining technologies at ‘K 2016’ trade fair

Every three years, the plastics industry gathers at K, the international trade fair for plastics and rubber in Düsseldorf. The Fraunhofer Institute for Laser Technology ILT will also be attending again and presenting many innovative technologies, such as for joining plastics and metals using ultrashort pulse lasers. From October 19 to 26, you can find the Fraunhofer ILT at the joint Fraunhofer booth SC01 in Hall 7.

K is the world’s largest trade fair for the plastics and rubber industry. As in previous years, the organizers are expecting 3,000 exhibitors and more than...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Experts from industry and academia discuss the future mobile telecommunications standard 5G

23.09.2016 | Event News

ICPE in Graz for the seventh time

20.09.2016 | Event News

Using mathematical models to understand our brain

16.09.2016 | Event News

 
Latest News

Chains of nanogold – forged with atomic precision

23.09.2016 | Life Sciences

New leukemia treatment offers hope

23.09.2016 | Health and Medicine

Self-assembled nanostructures hit their target

23.09.2016 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>