Surgeons and transplant centers nationwide increasingly have rejected hearts donated for transplantation despite a growing need for them, according to a new study by researchers at the Stanford University School of Medicine.
The study also found that the rejection of “marginal” donor hearts – those with undesirable qualities, such as being small or coming from an older donor – varied significantly across geographical regions. In other words, some hearts rejected in one region would be accepted in another.
“We’ve become more conservative over the past 15-20 years in terms of acceptance, which is particularly troubling because of the national shortage of donor hearts and the growing number of critically ill patients awaiting heart transplantation,” said Kiran Khush, MD, assistant professor of cardiovascular medicine. Khush, who treats heart transplant patients, is lead author of the study, which will be published online Feb. 10 in the American Journal of Transplantation.
Estimates show that more than 20,000 patients in the United States could benefit from heart transplant surgery each year. Yet only 1,949 patients received transplants in 2011, according to the study.
The findings point to a pressing need for a set of consistent, scientifically based guidelines to provide surgeons and transplant centers with a standardized method of determining whether a marginal donor heart should be used for transplantation.
“There is likely a significant number of suitable donor hearts that are not getting used,” said John Nguyen, a co-author of the study who is trained as a nurse and works as part of a clinical team at the Oakland-based California Transplant Donor Network, a federally designated organ procurement organization that helps facilitate organ donation to transplant centers across the nation. “Creating a more systematic way of evaluating these hearts based on scientific evidence could increase the number of heart transplants.”