Benck, Urs and Hoeger, Simone and Brinkkoetter, Paul T. and Gottmann, Uwe and Doenmez, Duygu and Boesebeck, Detlef and Lauchart, Werner and Gummert, Jan and Karck, Matthias and Lehmkuhl, Hans B. and Bittner, Hartmuth B. and Zuckermann, Andreas and Wagner, Florian and Schulz, Uwe and Koch, Achim and Bigdeli, Amir K. and Bara, Christoph and Hirt, Stephan and Berchtold-Herz, Michael and Brose, Stefan and Herold, Ulf and Boehm, Johannes and Welp, Henryk and Strecker, Thomas and Doesch, Andreas and Birck, Rainer and Kraemer, Bernhard K. and Yard, Benito A. and Schnuelle, Peter (2011) Effects of Donor Pre-Treatment With Dopamine on Survival After Heart Transplantation A Cohort Study of Heart Transplant Recipients Nested in a Randomized Controlled Multicenter Trial. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 58 (17). pp. 1768-1777. ISSN 0735-1097,
Full text not available from this repository. (Request a copy)Abstract
Objectives We determined the outcome of cardiac allografts from multiorgan donors enrolled in a randomized trial of donor pre-treatment with dopamine. Background Treatment of the brain-dead donor with low-dose dopamine improves immediate graft function after kidney transplantation. Methods A cohort study of 93 heart transplants from 21 European centers was undertaken between March 2004 and August 2007. We assessed post-transplant left ventricular function (LVF), requirement of a left ventricular assist device (LVAD) or biventricular assist device (BVAD), need for hemofiltration, acute rejection, and survival of recipients of a dopamine-treated versus untreated graft. Results Donor dopamine was associated with improved survival 3 years after transplantation (87.0% vs. 67.8%, p = 0.03). Fewer recipients of a pre-treated graft required hemofiltration after transplant (21.7% vs. 40.4%, p = 0.05). Impaired LVF (15.2% vs. 21.3%, p = 0.59), requirement of a LVAD (4.4% vs. 10.6%, p = 0.44), and biopsy-proven acute rejection (19.6% vs. 14.9%, p = 0.59) were not statistically different between groups. Post-transplant impaired LVF (hazard ratio [HR]: 4.95; 95% confidence interval [CI]: 2.08 to 11.79; p < 0.001), requirement of LVAD (HR: 6.65; 95% CI: 2.40 to 18.45; p < 0.001), and hemofiltration (HR: 2.83; 95% CI: 1.20 to 6.69; p = 0.02) were predictive of death. The survival benefit remained (HR: 0.33; 95% CI: 0.12 to 0.89; p = 0.03) after adjustment for various risks affecting mortality, including pre-transplant LVAD/BVAD, inotropic support, and impaired kidney function. Conclusions Treatment of brain-dead donors with dopamine of 4 mu g/kg/min will not harm cardiac allografts but appears to improve the clinical course of the heart allograft recipient. (Prospective Randomized Trial to Evaluate the Efficacy of Donor Preconditioning With Dopamine on Initial Graft Function After Kidney Transplantation; NCT00115115) (J Am Coll Cardiol 2011;58:1768-77) (C) 2011 by the American College of Cardiology Foundation
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COLD-PRESERVATION; RENAL DYSFUNCTION; DOSE DOPAMINE; ORGAN DONOR; INJURY; HYPOTHERMIA; PREDICTORS; THERAPY; CALCIUM; CELLS; antioxidants; cardiac transplantation; dopamine; ischemia; survival |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 02 Jun 2020 05:25 |
| Last Modified: | 02 Jun 2020 05:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/19967 |
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