Repairing cardiac allografts in situ

Abstract In this chapter the concept of repair rather than replacement by transplantation is presented. Repair of the heart, we have suggested, is the “restoration of a damaged to satisfactory function”. Our first example of repair is that reported in some 20% of patients requiring short term mechanical cardiac support after a cardiac insult. The case is then offered for the repair of the arrested ischaemic heart after withdrawal of futile treatment in an individual. Such recovered hearts with appropriate consent form the cornerstone of non heart beating heart donation or donation after circulatory determined death. This programme's impact upon clinical transplantation is explored and an aspiration made for the development of, initially repair of poorly performing donor heart leading to vital organ banking and ultimately repair directed towards the recipients on heart.