Prevalence, determinants, and correlates of coagulation necrosis and contraction band necrosis in donor hearts.
Adult
Female
Follow-Up Studies
Heart
/ physiopathology
Heart Transplantation
Humans
Male
Middle Aged
Myocardial Infarction
/ epidemiology
Necrosis
Prevalence
Thrombosis
/ epidemiology
Tissue Donors
/ supply & distribution
Tissue and Organ Procurement
/ statistics & numerical data
United States
/ epidemiology
coagulation necrosis
contraction band necrosis
heart transplantation
neurogenic stunned myocardium
stress-induced cardiomyopathy
Journal
Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
08
08
2018
revised:
19
10
2018
accepted:
26
12
2018
pubmed:
1
1
2019
medline:
4
4
2020
entrez:
1
1
2019
Statut:
ppublish
Résumé
Exploration of pathologic changes in donor hearts and finding the association of pathologic findings with potentially reversible cardiac condition may result in allowing such hearts to recover and be used for transplantation. We enrolled consecutive donors from one federally designated Organ Procurement Organization for one calendar year. Hearts rejected for transplantation underwent pathological examination. We studied the association of pathologic findings with the mechanism of death. A total of 81 hearts were rejected for transplantation. The most common pathologic findings were coagulation necrosis (CN) in 17.3% and contraction band necrosis (CBN) in 34.6%. Anoxic brain injury was present in 78.6% of the donors who had CN, and only in 29.9% of those without CN (P = 0.002). CBN was more commonly associated with subarachnoid hemorrhage (17.9% vs 1.9% of donors with and without CBN, P = 0.017). Only hearts with CBN had significantly lower LVEF (P = 0.017). Coagulation necrosis and CBN are the most common pathologic findings in the hearts rejected for transplantation. While CN is more prevalent in anoxic brain injury, CBN is more often present in subarachnoid hemorrhage. This may be clinically important because CBN is a pathologic hallmark of catecholamine-induced cardiomyopathy which is potentially reversible.
Sections du résumé
BACKGROUND
Exploration of pathologic changes in donor hearts and finding the association of pathologic findings with potentially reversible cardiac condition may result in allowing such hearts to recover and be used for transplantation.
METHODS
We enrolled consecutive donors from one federally designated Organ Procurement Organization for one calendar year. Hearts rejected for transplantation underwent pathological examination. We studied the association of pathologic findings with the mechanism of death.
RESULTS
A total of 81 hearts were rejected for transplantation. The most common pathologic findings were coagulation necrosis (CN) in 17.3% and contraction band necrosis (CBN) in 34.6%. Anoxic brain injury was present in 78.6% of the donors who had CN, and only in 29.9% of those without CN (P = 0.002). CBN was more commonly associated with subarachnoid hemorrhage (17.9% vs 1.9% of donors with and without CBN, P = 0.017). Only hearts with CBN had significantly lower LVEF (P = 0.017).
CONCLUSION
Coagulation necrosis and CBN are the most common pathologic findings in the hearts rejected for transplantation. While CN is more prevalent in anoxic brain injury, CBN is more often present in subarachnoid hemorrhage. This may be clinically important because CBN is a pathologic hallmark of catecholamine-induced cardiomyopathy which is potentially reversible.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13472Informations de copyright
© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.