The Ethics of Domino Heart Transplantation

Domino transplantation provides a further source of hearts for transplantation (Dark 1990; Baumgartner 1989; Cavarrochi 1989). It is essential that neither donors nor recipients are disadvantaged as a result of this practice (Sutor 1988; Rhenman 1989). We have studied the first 28 donors and recipients of the domino procedure at our institute and compared them with comparable groups of heart-lung and heart transplant recipients not involved in the domino procedure. Comparison was made of ischaemic time of in-house and distant procurement hearts, of ischaemic time for donors and non-donors of domino hearts, time in hospital and early survival figures at 3 months after transplantation.