The impact of cocaine on the donor heart: A case report

With a limited supply of donor hearts in the United States and a prevalent history of cocaine abuse among potential heart donors, the question of tran splanting the hearts of cocaine users presents a dilemma to the surgeon. We report a patient who died of the acute right ventricular failure of a hear t from a donor with a history of binge drinking and cocaine abuse and who h ad sustained traumatic brain death. The donor's serum was positive for coca ine prior to transplantation, and autopsy findings were consistent with coc aine cardiomyopathy. This case illustrates the importance of accurate donor history and toxicologic screen prior to heart transplantation and suggests that hearts of cocaine users should not be transplanted, especially in a s etting of traumatic brain death.