Expanding the donor pool for congenital heart disease transplant candidates by implementing 3D imaging-derived total cardiac volumes.

Abstract:

BACKGROUND:Heart transplant waitlist mortality remains high in infants <1 year of age and among those with CHD. Currently, the median accepted donor-to-recipient weight percentage is approximately 130% of the recipient's weight. We hypothesized that patients with CHD may accept a larger organ using novel 3D-derived imaging data to estimate donor and recipient TCV. METHODS:A single-center, retrospective study was performed using CT data for 13 patients with CHD and 94 control patients. 3D visualization software was used to create digital 3D heart models that provide an estimate of TCV. In addition, echocardiograms obtained prior to cross-sectional imaging were reviewed for presence of ventricular chamber dilation. RESULTS:Sixty-two percent (8/13) of patients with CHD had 3D-derived TCV resulting in a weight that was >130% larger than their actual weight. This was seen in single-ventricle patients following Blalock-Taussig shunt and Fontan palliation, and patients with biventricular repair. Of those, 75% (6/8) had reported moderate-to-severe ventricular chamber dilation by echocardiogram or cardiac magnetic resonance imaging. CONCLUSIONS:In a large portion of patients with CHD, 3D-derived TCV place the recipient at a higher listing weight than their actual weight. We propose obtaining cross-sectional imaging to better assess TCV in a recipient, which may increase the donor range for CHD recipients and improve organ utilization in pediatrics.

journal_name

Pediatr Transplant

authors

Shugh SB,Szugye NA,Zafar F,Riggs KW,Villa C,Lorts A,Morales DLS,Moore RA

doi

10.1111/petr.13639

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

e13639

issue

1

eissn

1397-3142

issn

1399-3046

journal_volume

24

pub_type

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