immunology allergic disorders
Heart Transplantation
Procedure
Donor hearts are preserved by hypothermic storage. They must be transplanted within 4 to 6 hours. Use of an in vitro pump system that modifies cell metabolism in the donor heart and thus may prolong transplant viability > 4 to 6 hours is under study. These pump systems more recently have allowed the use of cardiac grafts retrieved from donors after cardiac arrest. The recipient is placed on a bypass pump, and the recipient's heart is removed, preserving the posterior right atrial wall in situ. The donor heart is then transplanted orthotopically (in its normal position) with aortic, pulmonary artery, and pulmonary vein anastomoses; a single anastomosis joins the retained posterior atrial wall to that of the donor organ. Immunosuppressive regimens vary but are similar to those for Procedure or 