Survival Is Not Compromised in Donor Hearts with Echocardiographic Abnormalities

ObjectivesTo determine the effect of heart donors with echocardiographic abnormalities on short and long-term outcomes on heart transplant recipients.MethodsRetrospective chart review of heart donors used over 6 y. Donor charts provided demographic information, cause of death, and echo results. Recipient charts were queried for predischarge echo and survival results.ResultsFrom January 1999 to December 2005, 485 heart transplants were performed. Of these, 50 donors had 70 echo abnormalities. Mean donor age was 32 y (range 4–51 y). Echo abnormalities included wall motion abnormality in 30 (60%), left ventricular hypertrophy in 20 (40%), mitral regurgitation in 16 (32%), aortic regurgitation in 2 (4%), and left ventricle dilation in 2 (4%). Mean ejection fraction was 54.0% (range 40%–70%). Echo abnormalities post-transplant decreased significantly to 18 (64% decrease) patients with 21 (70% decrease) echo abnormalities. Wall motion abnormalities resolved in 27 (90% decrease) patients (P < 0.01), left ventricular hypertrophy resolved in 14 (70% decrease) patients (P < 0.01), and mitral regurgitation resolved in 12 (75% decrease) patients (P < 0.01). Aortic regurgitation and left ventricle dilation resolved in 2 patients. However, right ventricle dilation significantly increased in 8 patients (P < 0.01). Mean ejection fraction at discharge was 56.9% (range 45%–89%). Overall survival was 96% at a mean follow-up of 4 y (range 2–6 y).ConclusionMajority of echocardiographic abnormalities in donor hearts resolve prior to discharge and 4 y survival rates are excellent.