Orthotopic heart transplantation with concurrent coronary artery bypass grafting or previous stent implantation.

We describe three cases of donor hearts with preexisting coronary artery disease already diagnosed prior to transplantation: two were treated by coronary artery bypass grafting during the transplant procedure and one by angioplasty with stenting during the donor screening angiography. All three donor organs would otherwise have been rejected, depriving potential recipients of organ transplantation. All patients had an uneventful post-operative course with follow-up completed 22, 40 and 43 months after orthotopic transplantation showing patency of the stent and bypass grafts in the early (1 and 9 months) and late (22, 24 and 37 months) coronary angiography. Our results suggest that in this era of acute organ shortage donor hearts requiring bypass or stenting, which form a small but significant donor subgroup, can be used effectively and safely when matched to the recipients' age and medical condition.