Intensivist-Performed Transesophageal Echocardiography as a Screen for Organ Donation: A Four-Year, Single-Center Experience

K. M. Madden¹, T. C. Wray², K. Rainbird¹, I. Tawil², T. Dettmer², K. Azevedo², R. Venkataramani³, J. Marinaro²

¹New Mexico Donor Services, Albuquerque, NM, ²Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, ³Anesthesiology, University of New Mexico Health Sciences Center, Albuquerque, NM

Meeting: 2021 American Transplant Congress

Abstract number: 1254

Keywords: Allocation, Echocardiography, Heart

Topic: Clinical Science » Organ Inclusive » Deceased Donor Management and Intervention Research

Session Information

Session Name: Deceased Donor Management and Intervention Research

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Echocardiography is required for deceased heart donation, and transthoracic echocardiography is the traditional practice. At our institution, intensivists perform transesophageal echocardiography (TEE) and since 2016, intensivist TEE has been the primary evaluation method in brain dead (BD) heart donation. We aimed to determine our institution’s potential donor heart transplant outcomes after intensivist-performed TEE.

*Methods: A retrospective review of eligible BD donors with heart donation potential who underwent TEE was performed to evaluate the TEE interpretation, if the heart was allocated, and if the heart was ultimately transplanted. We also evaluated likelihood of transplant if a repeat TEE was performed.

*Results: From 01/01/2016 to 11/09/2020, 74 TEEs were performed on 62 eligible BD donors with heart donation potential. 48 (77%) hearts were allocated, of which 41 had TEEs read as normal. 29 (60%) were ultimately transplanted. Of the 19 hearts allocated but not transplanted, 11 (58%) were read by the intensivist as normal. Table 1 lists reasons eligible donor hearts with normal TEEs were not transplanted. Of the 12 donors requiring a second TEE due to reduced systolic function, the heart was not allocated for 1 (8%). Of the remaining 11, 7 were ultimately transplanted (64%).

*Conclusions: Intensivist-performed TEE at our institution resulted in the majority of donor hearts evaluated ultimately being transplanted over the four years studied. Future studies will compare intensivist-evaluated donor heart transplant outcomes with those of the prior transthoracic echocardiography driven era, as well as further examine the optimal time for the first TEE, or the repeat TEE, based on the data we have gathered.

Table 1: Donor Hearts with Normal TEE Not Transplanted (n=11)
Reason	Number of Donor Hearts (%)
List ran, no potential recipient identified	4 (36%)
Significant coronary artery disease on cardiac catheterization	3 (27%)
New vasopressor requirement prior to procurement	2 (18%)
Donor/recipient size mismatch noted in OR	1 (9%)
Development of new right ventricular dysfunction prior to OR	1 (9%)

To cite this abstract in AMA style:

Madden KM, Wray TC, Rainbird K, Tawil I, Dettmer T, Azevedo K, Venkataramani R, Marinaro J. Intensivist-Performed Transesophageal Echocardiography as a Screen for Organ Donation: A Four-Year, Single-Center Experience [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/intensivist-performed-transesophageal-echocardiography-as-a-screen-for-organ-donation-a-four-year-single-center-experience/. Accessed November 21, 2024.

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