Assessing Cardiac Transplant Viability with MRS
Résumé
Heart transplantation remains the treatment of choice for severe heart failure and end-stage cardiac disease. In a context of organ shortage and increasing inclusion of marginal donors, it is important to safely use the available grafts but without overestimating myocardial injury, which could result in discarding viable grafts. The development of biomarkers to assess cardiac graft viability before transplantation is thus of major interest. An important indicator of graft quality is given by high-energy phosphate compound concentrations that can be assessed noninvasively using 31P magnetic resonance spectroscopy. This method is also of use in assessing graft viability after transplantation when cardiac allograft vasculopathy can develop, which is associated with diffuse perfusion defects that potentially affect energy metabolism.