ORLANDO, Florida, Nov, 8, 2015 â€” A new 3D computer modeling system may significantly improve a surgeonâ€™s ability to select the best sized donor heart for children receiving heart transplants, according to research presented at the American Heart Associationâ€™s Scientific Sessions 2015.
Transplant centers currently assess compatibility of a potential donor heart by comparing the donor weight to the recipient weight and then picking an upper and lower limit based on the size of the patientâ€™s heart on chest X-ray. But the assessment is not precise and variations in size and volume can have a major effect on the recipientâ€™s outcome.
While survival in pediatric heart transplantation have improved, there are still too few donors to meet the demand, so â€œit is critical to optimize the range of acceptable donors for each child,â€ said study author Jonathan Plasencia, B.S., a Ph.D. student at Arizona State Universityâ€™s Image Processing Applications Lab in Tempe, Arizona.
â€œ3D reconstruction has tremendous potential to improve donor size matching,â€ he said. â€œWe feel that we now have evidence that 3D matching can improve selection and hope this will soon help transplant doctors, patients, and their parents make the best decision by taking some of the uncertainty out of this difficult situation.â€
To develop the new 3D system, the researchers created a novel library of healthy childrenâ€™s 3D reconstructed hearts using MRI and CT images in children weighing up to 99 pounds. They then used the library to predict the best donor body weight to ensure the correct heart size needed for pediatric transplant recipients. Then they used before and after images from infants who had already received a heart transplant. When they compared the post-operative data from the real infants with the virtual transplant images, they found that the 3D imaging system accurately identified an appropriate size heart.
â€œAs the virtual library grows, the ability to accurately predict donor heart volumes will improve, and analyzing future transplant cases using 3D matching will allow us to predict the true upper and lower limits of acceptable donor size,â€ he said. â€œThis may allow more effective organ allocation on a national scale and minimize the number of otherwise acceptable organs that are ultimately discarded.â€
Researchers suggested that one day transplant teams may be able to use the 3D process to perform virtual transplants before an actual procedure to rapidly measure a donated heart to ensure a better fit and to reduce the risk of mismatching in pediatric transplants.
The 3D process was a collaborative effort developed at the Arizona State University, along with researchers at Phoenix Childrenâ€™s Hospital and St. Josephâ€™s Hospital and Medical Center, also in Phoenix. The team was overseen by Steven D. Zangwill, M.D., medical director of Heart Transplant and Heart Failure at Phoenix Childrenâ€™s Hospital.
Although not yet to the point of replacing size matching for transplants, the investigators are encouraged by what they have found and have already implemented the techniques to supplement standard of care at Phoenix Childrenâ€™s Hospital, Plasencia said.
The big question is how long it will take to further test the technique and move it into actual use.
â€œWe are hoping that over the course of the next year, we will have a better sense of its validity in a prospective study,â€ Plasencia said.
This news release is featured in a news conference at 8 a.m. ET on Sunday, Nov. 8, 2015.
Co-authors are Justin Ryan, Ph.D..; Jacob Lindquist, B.S.; Susan Sajadi, B.S. Micheal Van Auker, Ph.D.; Randy Richardson, M.D.; Erik Ellsworth, M.D.; Susan Park, C.P.N.P.; Robyn Augustyn, B.S.; Richard Southard, M.D.; John Nigro, M.D.; Stephen Pophal, M.D.; David Frakes, Ph.D. and Steven Zangwill, M.D. Author disclosures are on the manuscript.
The study was not funded by any outside sources.
Note: Actual presentation is 4:30 p.m. ET, Sunday, Nov. 8, 2015.
- Any available downloadable video/audio interviews, B-roll, animation and images related to this news release are on the right column of the release link at http://newsroom.heart.org/news/3d-image-may-provide-better-size-match-for-child-heart-transplants?preview=0ff4c3ead96cebd403fb7f61d502b858
Video clips with researchers/authors of the studies will be added to the release link after embargo.
Congenital Heart Disease
Commonly Asked Questions About Children and Heart Disease
Congenital Heart Defects Tools and Resources
For more news from the AHAâ€™s Scientific Sessions 2015 follow us on Twitter @HeartNews #AHA15.
Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at http://www.heart.org/corporatefunding.
For Media Inquiries and AHA Spokesperson Perspective:
AHA News Media in Dallas: (214) 706-1173
AHA News Media Office, Nov. 7-11, 2015
at the Orange County Convention Center: (407) 685-5401
For Public Inquiries: (800) AHA-USA1 (242-8721)
heart.org and strokeassociation.org
Life is why, science is how . . . we help people live longer, healthier lives.