Impact of brain-death-induced transient myocardial dysfunction on long-term health of heart transplant recipients

Despite the many years that brain-dead donors have been a source for heart transplants, some uncertainty remains as to the impact of brain-death on the long-term outcome of the heart transplant recipients. Cardiac dysfunction may occur in up to 42% of adults with brain death, affecting a highly significant proportion of hearts that are transplanted[1,2]. Records of 246 donor hearts matched to recipients at UNMC between 2010 and 2017 were examined to determine long-term effect of brain-death-induced transient myocardial dysfunction (BDIMC). Data was also assessed to determine correlation between donor characteristics of age, gender, and cause of death and exhibition of BDIMC in donor hearts. It was found that 1-year and 5-year survival rates of recipients of donor hearts with BDIMC within the sample were on average lower than those seen in recipients of non-BDIMC donor hearts. While this result was not statistically significant (p = 0.18), the trend demonstrated in the data merits additional study into the effects of BDIMC in larger and more diverse sample sizes. No association between BDIMC and donor characteristics was found. Conclusions made by further study may aid health care workers in selection of hearts with highest survival rates for those in need. References include: Dujardin KS, McCully RB, Wijdicks EF, et al. Myocardial dysfunction associated with brain death: clinical, echocardiographic, and pathologic features. J Heart Lung Transplant. 2001;20(3):350-357. doi:10.1016/s1053-2498(00)00193-52. Fyfe, B., et al. (1996). Heart TransplantationAssociated Perioperative Ischemic Myocardial Injury. Circulation 93(6): 1133-1140.https://digitalcommons.unmc.edu/surp2020/1022/thumbnail.jp