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Some Imperfect Hearts OK for Transplant

Ventricular thickening didn't affect outcomes, could expand donor pool, experts say

By Ed Edelson
HealthDay Reporter


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MONDAY, March 17 (HealthDay News) -- A heart needn't be perfect to be used in a transplant, a new study shows.

Five-year results for people given hearts with mild-to-moderate left ventricular hypertrophy (LVH) -- a thickening of the heart's main pumping chamber -- were as good as for those who got hearts with no problems, cardiologists at Cedars-Sinai Medical Center in Los Angeles report in the March 25 issue of the Journal of the American College of Cardiology.

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The findings might help expand the donor pool for heart transplants, one expert said.

"Up to this time, any patient who had more than minor LVH would not be accepted into our donor pool because we thought we would have worse results over time. This paper suggests that is not the case," said Dr. Allan Stewart, director of aortic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center, in New York City.

In the Cedars-Sinai study, the largest of its kind to date, researchers reviewed outcomes for 427 patients who underwent heart transplant at the center between 1989 and 2004.

The survival rate of the 62 recipients of transplanted hearts with LVH was comparable with that of 365 people who got hearts without LVH, said study senior author Dr. Alfredo Trento, director of cardiothoracic surgery at Cedars-Sinai.

In the first 30 days, 98 percent of those getting heart with LVH survived, compared to 97 percent of those getting normal hearts. The five-year survival numbers were even better for people getting LVH hearts -- 84 percent, compared to 70 percent for those getting normal hearts. But those better results were a statistical quirk, he added quickly: "I don't think you can make any inference from that."

Cedars-Sinai surgeons began accepting LVH hearts "because the donor pool was not providing enough donors, so you have to go to less optimal -- but what we think are still good -- hearts," Trento said.

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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 3/17/2008

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SOURCES: Alfredo Trento, M.D., director, cardiothoracic surgery, Cedars-Sinai Medical Center, Los Angeles; Allan Stewart, M.D., director, aortic surgery, NewYork-Presbyterian Hospital/Columbia University Medical Center, New York City; March 25, 2008, Journal of the American College of Cardiology


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