Functional independence of donor and recipient cardiac tissues of single and double heart transplant patients revealed by chronobiology.

3 total (single) and 1 double-heart-transplant patients were studied for temporal changes in the electrical events of cardiac function. Results of statistical analyses document the existence of circadian rhythms in the donor and recipient P--P or R--R intervals. However, for 1 total-heart-transplant patient studied at intervals during the year following implant and the double-heart-transplant patient 5 mth after surgery, the period (tau) of the rhythm in the P--P or R--R interval of the recipient tissue deviated greatly from that of 24.0 h. For the total-heart-transplant patient studied 1 mth prior to death, the tau was 32.3 h; for the double-heart-transplant patient, the tau was 29.0 h. In both patients, the donor heart tissue continued to exhibit a 24-h rhythm. These findings imply that changes in tau for the rhythm in P--P or R--R interval may reflect aspects of disrupted physiologic, feedback, regulatory mechanisms or perhaps graft rejection. Although additional study is required, the possibility that alteration in tau is associated with rejection is intriguing since if documented, then the noninvasive monitoring of ECG and subsequent analysis of data for significant deviations of tau from 24.0 h will be useful as an additional tool for monitoring host tolerance for the heart implant.