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Related Experiment Videos

Donor heart selection: Wythenshawe experience.

N Khasati1, J Barnard, M N Bittar

  • 1From the Transplant Centre, South Manchester University Hospitals NHS Trust, Manchester, England.

Transplantation Proceedings
|April 26, 2005
PubMed
Summary

Donor hearts medically unsuitable for transplantation at one center showed significantly higher recipient mortality. Caution is advised when using these grafts, especially with multiple adverse factors, to improve heart transplant outcomes.

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Area of Science:

  • Cardiovascular Surgery
  • Transplantation Medicine
  • Organ Donation

Background:

  • Declining availability of suitable donor hearts necessitates exploring utilization of previously unacceptable donors.
  • Investigating outcomes of donor hearts deemed medically unsuitable by one center but transplanted elsewhere.

Purpose of the Study:

  • To evaluate the clinical outcomes of heart transplant recipients receiving grafts from donors initially declined for medical reasons.

Main Methods:

  • Retrospective analysis of 40 medically unsuitable donor hearts (Group 1) versus 104 suitable donor hearts (Group 2) transplanted between April 1998 and March 2003.
  • Data sourced from the United Kingdom Cardiothoracic Transplant Audit database.
  • Mortality analysis performed using SPSS software.

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Main Results:

  • Significantly higher mortality observed in recipients of Group 1 donor hearts compared to Group 2 (P < .0009).
  • Graft failure accounted for 50% of early deaths in the medically unsuitable donor group.
  • High-dose inotrope use, prolonged ischemic time (>3.5 hours), and high-risk recipients were associated with poor outcomes in Group 1.

Conclusions:

  • Donor hearts declined on medical grounds require careful evaluation before transplantation.
  • The presence of multiple adverse factors in a donor heart significantly increases transplant risk.