Successful cardiac transplantation with methanol or carbon monoxide-poisoned donors

Background. Patients succumbing to methanol or carbon monoxide poisoning ar e usually rejected for heart donation. Increasing demand for donors has lea d to the expansion of acceptance criteria and increased use of the marginal donor. Methods. We transplanted hearts from donors who had had methanol intoxicati on in three cases and carbon monoxide exposure in two cases. Standard donor evaluation criteria and transplantation techniques were used. Results. All of the transplants were successful. Three of the recipients re quired significant inotropic support for a few days postoperatively; howeve r, all of the hearts functioned well over the intermediate and long term. T wo recipients (1 from each group) died of complications other than heart fa ilure (1.5 and 2 years postoperatively). Conclusions. Successful heart transplantation can be achieved using the hea rts from patients succumbing to methanol or carbon monoxide poisoning. Rout ine evaluation of cardiac function and myocardial damage is adequate for sc reening these donors. Hearts from methanol-poisoning victims may require lo nger inotropic support postoperatively before complete recovery, but can pr ovide excellent long-term function and results. (C) 2001 by The Society of Thoracic Surgeons.