3D Modeling System Accurately Predicts Pediatric Donor Heart Volumes

A new three dimensional (3D) computer modeling system may more accurately identify the best donor heart for a pediatric transplant patient.

To develop the new 3D system, researchers at Arizona State University (ASU; Tempe, USA) and Phoenix Children’s Hospital (AZ, USA) first created a library of 3D reconstructed hearts in healthy children weighing up to 45 kilograms, using magnetic resonance imaging (MRI) and computerized tomography (CT) scans. They then used the virtual library to predict the best donor body weight/heart size correlation needed for pediatric transplant recipients. Concomitantly, they examined before and after images from infants who had already received a heart transplant.

When the researchers compared the post-operative data from the real infants with the virtual transplant images, they found that the 3D imaging system accurately identified an appropriate size heart, validating their findings. The researchers are currently expanding the virtual library to improve prognostic capabilities, thus allowing more effective organ allocation and minimizing the number of otherwise acceptable organs that are ultimately discarded. The study was presented at the annual American Heart Association (AHA) Scientific Sessions, held during November 2015 in Orlando (FL, USA).

“It is critical to optimize the range of acceptable donors for each child. 3D reconstruction has tremendous potential to improve donor size matching,” said lead author and study presenter Jonathan Plasencia, BSc, of the ASU image processing applications lab. “We feel that we now have evidence that 3D matching can improve selection and hope this will soon help transplant doctors, patients, and their parents make the best decision by taking some of the uncertainty out of this difficult situation.”

“Analyzing future transplant cases using 3D matching will allow us to predict the true upper and lower limits of acceptable donor size. The big question is how long it will take to further test the technique and move it into actual use,” concluded Mr. Plasencia, who is a PhD student at ASU. “One day transplant teams may be able to use the 3D process to perform virtual transplants before an actual procedure to rapidly measure a donated heart to ensure a better fit and to reduce the risk of mismatching in pediatric transplants.”

Transplant centers currently assess compatibility of a potential donor heart by comparing the donor weight to the recipient weight, and then picking an upper and lower limit based on the size of the patient’s heart on chest X-ray. But the assessment is not precise and variations in size and volume can have a major effect on the recipient’s outcome.

Related Links:
Arizona State University
Phoenix Children’s Hospital