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 Real-time imaging of lung lesions during surgery helps localize tumors and improve precision
30.07.2015 | American Association for Thoracic Surgery

nachricht Experimental MERS vaccine shows promise in animal studies
29.07.2015 | NIH/National Institute of Allergy and Infectious Diseases

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: Quantum Matter Stuck in Unrest

Using ultracold atoms trapped in light crystals, scientists from the MPQ, LMU, and the Weizmann Institute observe a novel state of matter that never thermalizes.

What happens if one mixes cold and hot water? After some initial dynamics, one is left with lukewarm water—the system has thermalized to a new thermal...

Im Focus: On the crest of the wave: Electronics on a time scale shorter than a cycle of light

Physicists from Regensburg and Marburg, Germany have succeeded in taking a slow-motion movie of speeding electrons in a solid driven by a strong light wave. In the process, they have unraveled a novel quantum phenomenon, which will be reported in the forthcoming edition of Nature.

The advent of ever faster electronics featuring clock rates up to the multiple-gigahertz range has revolutionized our day-to-day life. Researchers and...

Im Focus: Superfast fluorescence sets new speed record

Plasmonic device has speed and efficiency to serve optical computers

Researchers have developed an ultrafast light-emitting device that can flip on and off 90 billion times a second and could form the basis of optical computing.

Im Focus: Unlocking the rice immune system

Joint BioEnergy Institute study identifies bacterial protein that is key to protecting rice against bacterial blight

A bacterial signal that when recognized by rice plants enables the plants to resist a devastating blight disease has been identified by a multi-national team...

Im Focus: Smarter window materials can control light and energy

Researchers in the Cockrell School of Engineering at The University of Texas at Austin are one step closer to delivering smart windows with a new level of energy efficiency, engineering materials that allow windows to reveal light without transferring heat and, conversely, to block light while allowing heat transmission, as described in two new research papers.

By allowing indoor occupants to more precisely control the energy and sunlight passing through a window, the new materials could significantly reduce costs for...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

3rd Euro Bio-inspired - International Conference and Exhibition on Bio-inspired Materials

23.07.2015 | Event News

Clash of Realities – International Conference on the Art, Technology and Theory of Digital Games

10.07.2015 | Event News

World Conference on Regenerative Medicine in Leipzig: Last chance to submit abstracts until 2 July

25.06.2015 | Event News

 
Latest News

Tool making and additive technology exhibition: Fraunhofer IPT at Formnext

31.07.2015 | Trade Fair News

First Siemens-built Thameslink train arrives in London

31.07.2015 | Transportation and Logistics

California 'rain debt' equal to average full year of precipitation

31.07.2015 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>