AI Article Synopsis

  • The Adonhers protocol allows for utilizing older donor hearts (up to 65 years) if stress echo screening shows normal results, aiming to address the shortage of donor hearts.
  • An infrastructure was developed to enable a "second opinion" on stress echo images from peripheral labs sent to a central lab in Pisa, ensuring consistency and reliability in donor heart selection.
  • The study demonstrated a 100% feasibility in simulating the system with remote assessments and successfully utilized the protocol in actual donor cases, leading to safe heart transplants for six out of eight marginal recipients.

Article Abstract

Background: To resolve the current shortage of donor hearts, we established the Adonhers protocol. An upward shift of the donor age cut-off limit (from the present 55 to 65 years) is acceptable if a stress echo screening on the candidate donor heart is normal. This study aimed to verify feasibility of a "second opinion" of digitally transferred images of stress echo results to minimize technical variability in selection of aged donor hearts for heart transplant.

Methods: The informatics infrastructure was created for a core lab reading with a second opinion from the Pisa stress echo lab. To test the system, simulation standard stress echo cineloops were sent digitally from 5 peripheral labs to the central core lab.Starting January 2009, real marginal donor stress echos were sent via internet to the central core echo lab, Pisa, for a second opinion before heart transplant.

Results: In the simulation protocol, 30 dipyridamole stress echocardiograms were sent from the five peripheral echo labs to the central core lab in Pisa. Both the echo images and reports were correctly uploaded in the web system and sent to the core echo lab; the second opinion evaluation was obtained in all cases (100% feasibility). In the transplant protocol, eight donor cases were sent to the Pisa core lab for the second opinion protocol, and six of them were transplanted in marginal recipients.

Conclusions: Second-Opinion Stress Tele-Echocardiography can effectively be performed in a network aimed to safely expand the heart donor pool for heart transplant.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887413PMC
http://dx.doi.org/10.1186/1476-7120-8-20DOI Listing

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