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Extended donor ischemic times and recipient outcome after orthotopic cardiac transplantation
J C Mullen1, M J Bentley, D L Modry
1University of Alberta, Edmonton, Canada. jmullen@ualberta.ca
Insights
Extended donor ischemic times did not significantly impact heart transplant survival rates. This study found no increased mortality at 30 days, 90 days, or 10 years with longer ischemic times.
Area of Science:
- Cardiology
- Transplantation Medicine
- Surgical Outcomes
Background:
- The impact of donor ischemic time on heart transplant outcomes remains debated.
- Optimizing donor organ viability is crucial for successful transplantation.
Purpose of the Study:
- To investigate the relationship between extended donor ischemic times and patient mortality after heart transplantation.
- To identify predictors of short-term and long-term survival following heart transplant procedures.
Main Methods:
- Retrospective analysis of 261 heart transplantations performed between 1985 and 1999.
- Patients categorized into two groups: donor ischemic time ≤4 hours and >4 hours.
- Analysis of donor and recipient factors influencing 30-day and 90-day survival.
Main Results:
- No significant difference in 30-day mortality between shorter (7%) and longer (13%) ischemic time groups (P=0.14).
- No significant difference in 90-day mortality between shorter (10%) and longer (16%) ischemic time groups (P=0.27).
- Similar 10-year actuarial survival rates observed between groups (P=0.33). Cardiopulmonary bypass time and lower donor weight were significant predictors of mortality.
Conclusions:
- Prolonged donor ischemic times were not significantly associated with reduced 30-day, 90-day, or 10-year survival.
- Findings suggest that extended ischemic times may be safely accommodated in heart transplantation under certain conditions.
Background:
The effect of extended donor ischemic times on mortality following heart transplantation is a matter of considerable debate.
Patients And Methods:
A retrospective study of the 261 consecutive heart transplantations performed at the centre (University of Alberta, Edmonton, Alberta) between July 1985 and June 1999 was conducted. Patients were divided into the following two groups based on donor ischemic time: 4 h or less and longer than 4 h. Donor and recipient factors were analyzed for their effects on 30-day and 90-day survival.
Results:
Thirty-day mortality was not significantly greater with prolonged donor ischemic times (13%) than with shorter ischemic times (7%, P=0.14). There was also no significant increase in 90-day mortality with longer ischemic times (16%) than with shorter ischemic times (10%, P=0.27). Actuarial survival (10 years) was similar between the groups (P=0.33). Predictors of 30-day and 90-day mortality were cardiopulmonary bypass time (P<0.001 and P<0.001, respectively) and lower donor weight (P=0.008 and P=0.02, respectively).
Conclusions:
Longer donor ischemic times were not significantly related to decreased 30-day, 90-day or 10-year actuarial survival.
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