European Journal of Cardio-Thoracic Surgery, Vol 10, 505-512, Copyright © 1996 by European Association for Cardio-thoracic Surgery
Banking cryopreserved heart valves in Europe: assessment of a 5-year operation in an international tissue bank in Brussels
Y Goffin, D Grandmougin and B Van Hoeck
European Homograft Bank International Association, Brussels, Belgium.
OBJECTIVE: The heart valve bank of the European Homograft Bank has been set
up in 1988 to meet the growing demand of cardiac surgeons for various sized
and quality controlled cryopreserved homografts. METHODS: Heart valve
donors less than 60 years of age were classified in 3 categories:
multiorgan donors with non transplantable hearts, recipients of cardiac
transplantation and non beating heart cadavers with a warm ischemic time of
less than 6 hours. Past history and biology were checked for transmissible
diseases. Preparation, progressive freezing and storage in liquid nitrogen
vapors, and quality control were according to the standards of the Belgian
Ministry of Health. RESULTS: From end January 1989 to end May 1994, 989
homograft valves were cryopreserved (514 pulmonary, 475 aortic and 3
mitral) whereas 962 valves were discarded. The first cause of rejection
being a major macroscopic lesion (41.48%). 138 hearts accepted at
inspection were contaminated and 43 cases remained so after antibiotics. 38
cases were positive for hepatitis B or C. Complication at distribution and
thawing included 10 instances of bag rupture and 15 of transversal fracture
through the wall of the conduit. 477 aortic, 474 pulmonary valves as well
as one mitral were implanted between May 1989 and May 1994, either for left
or right ventricular outflow tract reconstruction. In the left ventricular
outflow tract series 111 aortic and 23 pulmonary homograft valves were used
in cases of native endocarditis, prosthetic endocarditis or recurrent
endocarditis after homograft implantation. 9.6% of the requests could no be
satisfied. Regular follow up information was available from 382
implants-40.1% only. CONCLUSIONS: The assessment of 5 years operation of
the heart valve bank indicates: 1) the efficiency of selecting,
cryopreserving and allocating quality controlled homograft valves from a
large pool of donor hearts provided by a network of hospitals; 2) the
difficulty of obtaining regular follow up information on the implants.
