“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,” Dr. Tonino Bombardini, Scientific Coordinator of the Aged Donor Heart Rescue by Stress Echo (ADONHERS) Project, Pisa, Italy
Lack of Confidence in Approved Hearts
In Europe each year, there are about 4,500 hearts that have been approved for a transplant that are not even being used. Bombardini and his team of researchers discovered that pharmacological stress echocardiography can detect previously rejected hearts which may be suitable for transplantation.
The ADONHERS project’s research included 47 hearts which were previously shown to be eligible for transplantation. However, these hearts were then rejected by the transplant community, mainly due to the advanced age of the donor or for other risk factors, such as coronary heart disease.
Putting Rejected Hearts to the Test
The researchers performed dipyridamole stress echocardiography on 44 of the hearts to look for coronary artery disease or heart muscle abnormalities. Dipyridamole is a medication that reduces thrombus or blood clot formation. The other three hearts underwent dobutamine stress echocardiography. Dobutamine is a drug used to treat heart failure and cardiogenic shock.
The testing identified 35 hearts that were not diseased, of which, 29 were successfully transplanted. One month after transplantation, 26 of the patients had normal heart structure and function, while the other 3 had only minor single vessel disease. Just over two years later, 26 patients were still alive.
In his concluding remarks Bombardini stated that their research results demonstrated pharmacological stress echocardiography can 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,” he added.
What advancements do you see taking us to the next level in echocardiography? I encourage you to share your thoughts, via a comment below.