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  • Rosa Emilia Moraes

Donors with Wolff-Parkinson-White syndrome expand possibilities in heart transplantation



Using non-standard donors may be a strategy to reduce mortality on the

waiting list for a transplant. The literature reports an increasing number of successful cases

of transplants performed with donors with less severe or correctable heart diseases,

demonstrating the concrete possibility of successful treatment.

 

Article: NAG Solf, R Honorato, A Fiorelli, F. Bacal, F. Jatene. Use of donor with Wolff-Parkinson-White syndrome in heart transplantation: Report of two cases and review of literature. Brazilian Journal of Transplantation, 25(3):e0722, 2022. https://doi.org/10.53855/bjt.v25i3.443_en

 

Less waiting, more chances: donors with Wolff-Parkinson-White syndrome expand possibilities in heart transplantation


Performing a transplant is a therapeutic option to increase patients'; quality and life expectancy with refractory heart disease. Unfortunately, one of the most significant difficulties of this procedure is the shortage of donors, which reflects in a long waiting list and a high patient mortality rate during this period.


Strategies to expand the number of donors have been constantly sought and agreed upon by the scientific community involved in transplants. One of these approaches is the relaxation of specific criteria that generally disqualify a donor, such as an advanced age group or having less severe or correctable heart disease. These are 'marginal donors'; who, under conventional transplant guidelines, would be refused as potential organ donors (WITTWER; WHALERS, 2008).


In the wake of successful cases reported in the literature, researchers from Instituto do Coração (InCor) - a public hospital specialized in high complexity cardiology and recognized center for research and learning at the Faculty of Medicine of São Paulo, present the article "Use of donor with Wolff-Parkinson-White Syndrome in heart transplantation: Report of two cases and review of the literature", published in the Brazilian Journal of Transplantation, v. 25, n. 3, 2022.


Wolff-Parkinson-White syndrome (WPWS) is a relatively rare congenital disorder where there may be cardiac arrhythmia related to the existence of an extra electrical pathway in the heart that accelerates the patient's heartbeat. In some cases, it is asymptomatic and has little or no evidence on ECG exams.


The present study contributes with two more case reports of transplants with WPWS donors, performed at Instituto do Coração, both with favorable outcomes. It also presents a table with data from eight other articles that composed the literature review on the subject. Although patient management and treatment management varied among the cases analyzed, the outcome of all of them was considered positive or acceptable.


Based on what was exposed by the authors, it is possible to conclude that a careful assessment of the conditions of both patients — both the marginal donor and the potential recipient — can determine the risk/benefit ratio of each case in its concreteness. Even with incipient literature on the subject, the identification of suboptimal and previously disregarded donors can be considered to expand the contingent of organ donors.


 

Read more (References):


Wittwer T, Wahlers T. Marginal donor grafts in heart transplantation: lessons learned from 25 years of experience. Transpl Int. 2008 Feb;21(2):113-25. doi: 10.1111/j.1432-2277.2007.00603.x. Epub 2007 Dec 5. PMID: 18062790.

 

Links


Instituto do Coração 


Faculdade de Medicina da Universidade de São Paulo


Brazilian Journal of Transplantation

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