Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3867_Библиотеки_им_академика_М_И_Перельмана

The use of donor hearts with LVH has yielded mixed results in terms of recipient outcomes. Kuppahally et al. [20] reported that recipients of donor hearts with LVH (≥ 1.2cm) had worse survival and a higher incidence of cardiac allograft vasculopa­thy (CAV). Subsequently, Pinzon et al. [21] reviewed the UNOS database between 2006 and 2010 with almost 3000 recipients and stratified donor hearts into groups without LVH (< 1.1cm), with mild LVH (1.1–1.3cm), and with moderate-severe LVH (≥ 1.4cm). They found similar 30-day and 1-year survival rates across the recipients in all three groups. However, hearts from donors with additional risk factors such as older age or prolonged cold ischemic time (≥4h) exhibited worse survival [21], suggesting an association between LVH and other donor risk factors. The 2010 ISHLT guidelines for the care of heart transplant recipients state that using donor hearts with LVH (wall thickness<1.4cm) and without accompany­ing electrocardiograms (ECG) findings of LVH may be appropriate (class IIa; level of evidence C) [22]. Thus, the authors suggest that it is reasonable to avoid a donor heart presenting with posterior wall and interventricular septum thick­ness>14mm during diastole. The presence of aortic valve disease (stenosis or insufficiency) in the absence of left ventricular hypertrophy should not preclude donor considerations.