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Background Left ventricular systolic dysfunction (LVSD) accounts for almost 25% of nonacceptance of potential donor hearts. Previous smaller, single-center studies showed that LVSD following brain death may be transient, and such hearts can be successfully resuscitated with resolution of LVSD, then transplanted. Objectives This study evaluated outcomes of donor hearts with LVSD on initial transthoracic echocardiogram (TTE) that resolved during donor management. Methods We reviewed echocardiograms of all cardiac donors in the United Network of Organ Sharing database that were transplanted from January 1, 2007, to September 30, 2015, and identified 472 donor hearts with LVSD (left ventricular ejection fraction [LVEF] ≤40%) on initial TTE that resolved (LVEF ≥50%) during donor management on a subsequent TTE. These patients comprised the improved donor LVEF group. These were compared with donor hearts with normal LVEF (LVEF ≥55%) on the initial TTE for recipient mortality, cardiac allograft vasculopathy (CAV), and primary graft failure (PGF). Results There was no significant difference in recipient mortality at 30 days, 1 year, 3 years, and 5 years of follow-up, nor any difference in rates of PGF at 90 days and CAV at 5 years between recipients of donor hearts with improved LVEF and recipients of donor hearts with initially normal LVEF. Post-transplant length of stay was also similar between the 2 groups. Using propensity scores, 461 transplants in the improved-donor LVEF group were matched to 461 transplants in the normal-donor LVEF group. There was no significant difference in PGF at 90 days or recipient mortality after up to 5 years of follow-up. Conclusions In the largest analysis of donor hearts with transient LVSD, we found that such hearts can be successfully resuscitated and transplanted without increasing recipient mortality, CAV, or PGF. These results underscore the importance of appropriate donor management and should help to increase utilization of donor hearts with transient LVSD.

Cardiac sarcoidosis is notoriously difficult to diagnose and treatment protocols for the disease are not well-defined. The use of cardiac positron emission tomography (PET) imaging has been suggested in guiding immunosuppression. We sought to review the utilization of cardiac PET guided

Intravenous (IV) boluses of nondihydropyridine calcium channel blockers (CCBs) or beta-blockers (B-blockers) are often used for acute rate control in patients with atrial fibrillation (AF) with rapid ventricular response (RVR). However, due to their negative chronotropic and inotropic properties

We thank Dr. Madias and Dr. El-Battrawy et al. for their thoughtful comments on our recently published study [(1)][1], which showed that donor hearts with left ventricular systolic dysfunction (LVSD) that are successfully resuscitated can be transplanted without increasing recipient mortality

The reproducibility of cardiopulmonary exercise testing (CPX) has previously been reported in patients with NYHA Class II-III heart failure but not in patients with LVAD support. These two patient populations are known to have differing hemodynamic and metabolic responses to exercise. Here, we

Hydralazine-isosorbide dinitrate (H-ISDN) carries an indication for treating systolic heart failure (HF). Hydralazine-isosorbide mononitrate (H-ISMN) does not carry this indication, but is used nonetheless as ISMN is once a day, while ISDN is three times a day. How effective H-ISMN is compared to H

Center volume is a determinant of outcomes in patients requiring complex medical treatments. We evaluated the effect of center volume on in-hospital mortality in patients with a primary discharge diagnosis of heart failure (HF). A retrospective analysis of adult patients with a primary discharge

The impact of remote pulmonary artery pressure (PAP) monitoring on quality of life (QOL) and exercise capacity in outpatients with chronic heart failure is unknown. Sixty six outpatients with NYHA class III heart failure were screened for implantation of a PAP monitoring device, CardioMEMS (CM).

The effect of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on renal function during continuous flow left ventricular assist device support is unknown. A retrospective analysis was conducted in all patients who underwent CF LVAD placement at our center

The impact of Mineralocorticoid Receptor Antagonists (MRAs) on cardiac function during Continuous Flow Left Ventricular Assist Device (CF LVAD) support remains unknown. A post-hoc analysis of a prospective study conducted at our center to evaluate the effect of combining pharmacological

The elderly (≥65 years) form the majority of heart failure (HF) patients and are at risk for worse outcomes; however, there is a lack of risk stratification tools designed specifically for this population. Frailty scoring has been successfully used in the general geriatric assessment, hence we