The recipient becomes a donor: Allograft aortic valves from the excised hearts of cardiac transplant patients

Autor: Peter Ruygrok, Lois C. Armiger, H. Arthur Coverdale, Kenneth J. Graham, Trevor M. Agnew, Pam F. Aldersley, Alan R. Kerr, Marianne G. Strickett, Ralph M.L. Whitlock, Simon R. Dixon
Rok vydání: 1998
Předmět:
Zdroj: The Asia Pacific Heart Journal. 7:178-181
ISSN: 1328-0163
DOI: 10.1016/s1328-0163(98)90024-0
Popis: Background: The indications for aortic valve replacement with an allograft valve are well established, but the availability of such valves is limited. A potential source is from the excised hearts of patients undergoing heart transplantation (HTX). Methods: The retrieval and use of allograft aortic valves taken from the 85 excised hearts of HTX recipients during 1987–1997 was reviewed. Freedom from death or reoperation and the functional status of the recipients of these allograft valves were determined. Results: Seventeen allografts (20%) from HTX patients were used, accounting for 2.7% of the total allografts implanted (n=620). Two cryopreserved valves remained available for implantation, and 2 were being processed. In addition, one was thawed in theatre and not used. Reasons for not retrieving the remaining valves were: hearts not inspected or no record (34), valves did not meet selection criteria (21), valves damaged during excision (7) and prosthetic valve in aortic position (1). Establishment of a more rigorous routine in the past 5 years has improved retrievals by reducing the first reason. For the 17 recipients (mean age 47, range 19–83), allograft valves were chosen because: warfarin undesirable (7), small aortic root (4), old age (3), endocarditis (2), root replacement (1). At a mean of 49 months after implantation, 15 patients were alive (4-year freedom from death 85%). One further patient had undergone elective replacement with a prosthetic valve (4-year freedom from death or valve replacement 79%). The NYHA functional class was I in 14 patients and H in 1. Conclusions: Aortic valves from HTX patients' excised hearts are a small but valuable and important potential source of allografts. Knowledge that a part of their diseased heart may be used to treat another patient may help HTX patients endure the emotional stresses of transplantation.
Databáze: OpenAIRE
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