Post-transplant nerve regrowth better with young hearts, quick surgery

DALLAS, July 9 Spontaneous nerve regeneration after a heart transplant is more likely in cases involving young donors, young recipients and fast, uncomplicated surgery, researchers report in today's rapid access issue of Circulation: Journal of the American Heart Association.

Nerve regrowth (reinnervation) to the left ventricle can improve exercise performance, blood flow regulation, and ventricular function. It also allows the sensation of chest pain as an important warning sign of coronary blockage.

Sympathetic nerve fibers are severed during heart transplant surgery. Reinnervation takes time, so it is more frequently observed months or years after surgery. Reinnervation often is partial, but some patients experience no regrowth, explains lead author, Frank M. Bengel, M.D., an assistant professor at Nuklearmedizinische Klink und Polinklinik der Technische Unviersitat in Munchen, Germany. German scientists explored factors that may influence reinnervation in the largest group of patients assessed for ventricular reinnervation to date. The study also investigated the impact of regrowth on transplant survival.

Seventy-seven heart transplant patients (11 of them women) who were not experiencing organ rejection or other severe problems were examined with positron emission tomography (PET scan). A PET scan provides a cross-sectional image of the heart and heart tissue function.

Follow-up ranged from 1.5 years to 19 years after transplantation. Recipients ranged in age from 23 to 60; donor age ranged from 13 to 59. Duration of surgery (measured by the amount of time the recipients' aorta was clamped) varied from about a half hour to nearly 3 hours.

In 52 patients, researchers found partial reinnervation, while 25 patients had no evidence of nerve regrowth when checked at various times after surgery. Among those with regrowth, nerves were restored in 21 percent of the left ventricular heart muscle. Reinnerva

Contact: Bridgette Mc Neill
American Heart Association

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