HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hartmuth B. Bittner Edward P. Chen Shankha S. Biswas Peter Van Trigt, III Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bittner, H. B. Articles by Davis, R. D. Search for Related Content PubMed PubMed Citation Articles by Bittner, H. B. Articles by Davis, R. D.

Ann Thorac Surg 1999;68:1605-1611
© 1999 The Society of Thoracic Surgeons

---

Original Articles

Right ventricular dysfunction after cardiac transplantation: primarily related to status of donor heart

^a Division of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina, USA

Address reprints request to Dr Biswas, Division of Cardiothoracic Surgery, Duke University Medical Center, PO Box 31044, Durham, NC 27710
e-mail: ssb1{at}acpub.duke.edu

Presented at the Poster Sessions of the Thirty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 25–27, 1999.

Background. It is unclear whether right ventricular dysfunction after transplantation is due to donor brain death-related myocardial injury or recipient pulmonary hypertension.

Methods. A canine donor model of brain death and a monocrotaline pyrrole-induced chronic pulmonary hypertension recipient model were established, and used for 30 orthotopic bicaval cardiac transplantations divided into three groups: Controls (group A, normal donor/recipient), group B (brain-dead donors/normal recipient), and group C (normal donor/recipients with pulmonary hypertension). Right ventricular function was measured before transplant and brain death, 4 hours after brain death, and after transplant (1 hour off bypass) by load-independent means plotting stroke work versus end-diastolic volume during caval occlusion. Right ventricular total power and pulmonary vascular impedance were determined by Fourier analysis.

Results. In comparison to the control group right ventricular preload-recruitable stroke work and total power decreased significantly after brain death and transplant in group B (from 22.7 x 10³ erg (±1.2) at baseline to 15.6 x 10³ (±0.9) after brain death and to 11.3 x 10³ (±0.9) after transplant). In group C there was a significant increase in pulmonary artery pressure, impedance, right ventricular preload-recruitable stroke work, total power after transplant.

Conclusions. Normal donor hearts adapt acutely to the recipient’s elevated pulmonary vascular resistance by increasing right ventricular power output and contractility. Brain death caused significant right ventricular dysfunction and power loss, which further deteriorated after graft preservation and transplantation. The effects of donor brain death on myocardial function contribute to right ventricular dysfunction after cardiac transplantation.

This article has been cited by other articles:

				S. C. Stoica, D. K. Satchithananda, P. A. White, L. Sharples, J. Parameshwar, A. N. Redington, and S. R. Large Brain death leads to abnormal contractile properties of the human donor right ventricle J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 116 - 123. [Abstract] [Full Text] [PDF]

				E. Eroglu, L. Herbots, J. Van Cleemput, W. Droogne, P. Claus, J. D'hooge, B. Bijnens, J. Vanhaecke, and G. R. Sutherland Ultrasonic strain/strain rate imaging--a new clinical tool to evaluate the transplanted heart Eur J Echocardiogr, June 1, 2005; 6(3): 186 - 195. [Abstract] [Full Text] [PDF]

				G. Szabo, P. Soos, U. Heger, C. Flechtenmacher, S. Bahrle, Z. Zsengeller, C. Szabo, and S. Hagl Poly(ADP-ribose) polymerase inhibition attenuates biventricular reperfusion injury after orthotopic heart transplantation Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 226 - 234. [Abstract] [Full Text] [PDF]

				N. A. G. Solomon, J. R. McGiven, P. M. Alison, P. N. Ruygrok, D. A. Haydock, H. A. Coverdale, and T. M. West Changing donor and recipient demographics in a heart transplantation program: influence on early outcome Ann. Thorac. Surg., June 1, 2004; 77(6): 2096 - 2102. [Abstract] [Full Text] [PDF]

				R. S. Poston and B. P. Griffith Heart Transplantation J Intensive Care Med, January 1, 2004; 19(1): 3 - 12. [Abstract] [PDF]

				S. C. Stoica, D. K. Satchithananda, C. Atkinson, P. A. White, A. N. Redington, M. Goddard, T. Kealey, and S. R. Large The energy metabolism in the right and left ventricles of human donor hearts across transplantation Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 503 - 512. [Abstract] [Full Text] [PDF]

				E. A. Bocchi and A. Fiorelli The paradox of survival results after heart transplantation for cardiomyopathy caused by Trypanosoma cruzi Ann. Thorac. Surg., June 1, 2001; 71(6): 1833 - 1838. [Abstract] [Full Text] [PDF]