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May 7, 1997

Prostate Cancer Transmitted in an Orthotopic Heart Transplant-Reply

Author Affiliations

University of Pennsylvania Philadelphia

JAMA. 1997;277(17):1355. doi:10.1001/jama.1997.03540410033023

In Reply.  —In response to Drs Kohr and Pollack, when harvesting the liver or kidneys, an extensive exploratory laparotomy is performed to look for abnormalities prior to cross clamping, and this was done in this case, with no abnormality found. The article by Rosenthal et al1 that Pollack cites in his letter reports mobilization of the ureters prior to harvest, but this is in the context of kidney procurement alone, not multiorgan procurements. We, as well as the majority of transplant surgeons, use the rapid flush techique2 and consider it a standard and accepted method of practice. It is routine practice at our institution to perform the rapid flush technique with the majority of the dissection following cold flush for multiorgan procurements. By the time the ureters are thoroughly dissected deep in the pelvis and the kidneys are harvested, the heart has been removed and is on its way back

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