Aliabadi-Zuckermann, Arezu Z. and Goekler, Johannes and Kaider, Alexandra and Riebandt, Julia and Moayedifar, Roxana and Osorio, Emilio and Haberl, Thomas and Angleitner, Phillipp and Laufer, Guenther and Forsythe, John and Knezevic, Ivan and Skoric, Bosko and Erasmus, Michiel and van Cleemput, Johan and Caliskan, Kadir and De Jonge, Nicolaas and Szabolcs, Zoltan and Prodan, Zsolt and Wasler, Andrae and Bara, Christoph and Udovicic, Mario and Sandhaus, Tim and Garbade, Jens and Ruhparwar, Arjang and Schoenrath, Felix and Hirt, Stephan and Antretter, Herwig and Schulz, Uwe and Richter, Manfred and Thul, Josef and Barten, Markus J. and Haneya, Assad and Aleksic, Ivan and Eifert, Sandra and Berchtold-Herz, Michael and Smits, Jacqueline and Zuckermann, Andreas O. (2018) Donor heart selection and outcomes: An analysis of over 2,000 cases. JOURNAL OF HEART AND LUNG TRANSPLANTATION, 37 (8). pp. 976-984. ISSN 1053-2498, 1557-3117
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND: Decision-making when offered a donor heart for transplantation is complex, and supportive data describing outcomes according to acceptance or non-acceptance choices are sparse. Our aim was to analyze donor heart acceptance decisions and associated outcomes at a single center, and after subsequent acceptance elsewhere. METHODS: This investigation was a retrospective analysis of data obtained from the University of Vienna Medical Center and Eurotransplant centers for the period 2001 to 2015 RESULTS: Our center accepted 31.8% (699 of 2,199) of donor hearts offered. Unlike other centers, the acceptance rate, with or without transplantation, did not increase over time. Of the donor hearts rejected by our center, 38.1% (572 of 1,500) were later accepted elsewhere. Acceptance rates were twice as high for donor hearts initially rejected for non-quality reasons (339 of 601, 56.4%) compared with initial rejection for quality reasons (233 of 899, 25.9%). Three-year patient survival rate was 79% at Vienna; for donor hearts initially rejected by Vienna for non-quality reasons or quality reasons, it was 73% and 63%, respectively (p < 0.001). Outcomes at other centers after transplantation of grafts rejected by Vienna varied according to the reason for rejection, with good 3-year survival rates for rejection due to positive virology (77%), high catecholamines (68%), long ischemic time (71%), or low ejection fraction (68%), but poor survival was observed for hearts rejected for hypernatremia (46%), cardiac arrest (21%), or valve pathology (50%). CONCLUSIONS: A less restrictive policy for accepting donor hearts at our center, particularly regarding rejection for non-quality reasons or for positive virology, high catecholamine levels, longer ischemic time, or low ejection fraction, could expand our donor pool while maintaining good outcomes. (C) 2018 International Society for Heart and Lung Transplantation. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CARDIAC-ARREST; INTERNATIONAL SOCIETY; TRANSPLANTATION; RECIPIENT; SURVIVAL; CRITERIA; IMPACT; REGISTRY; AGE; heart transplantation acceptance; quality; survival; donor hear |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Feb 2020 13:59 |
| Last Modified: | 12 Feb 2020 13:59 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14155 |
Actions (login required)
 |
View Item |
