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Updated: Jan 22, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Does duration of donor brain injury impact heart transplantation outcomes?
Alexander Kogan1,2, Eilon Ram1,2, Eyal Nachum1,2
1Heart Transplantation Unit, Sheba Medical Center, Ramat Gan, Israel.
Insights
Pre-transplantation time intervals, including brain injury time and brain death interval, do not impact heart transplant (HT) outcomes like mortality or rejection. This suggests greater flexibility in organ allocation and availability for HT candidates.
Area of Science:
- Cardiology
- Transplantation Medicine
- Immunology
Background:
- Optimizing heart transplant (HT) outcomes is crucial for patient survival.
- Understanding the impact of pre-transplantation donor factors is essential for improving graft success.
- Time intervals from donor brain injury to organ procurement are critical metrics.
Purpose of the Study:
- To investigate the implications of pre-transplantation time intervals on heart transplant (HT) outcomes.
- To determine if brain injury time (BIT), brain death interval (BDI), and allograft ischemia affect mortality and rejection.
- To inform clinical decisions regarding HT allocation and organ availability.
Main Methods:
- Retrospective analysis of 173 heart transplant recipients between 1997 and 2017.
- Definition of key time intervals: Brain Injury Time (BIT), Brain Death Interval (BDI), and Allograft Ischemia.
- Kaplan-Meier survival analysis and comparison of rejection rates between patient subgroups based on time intervals.
Main Results:
- Prolonged BIT, BDI, allograft ischemia, and total injury time did not significantly affect patient mortality or rejection rates.
- Subgroup analysis of short (<97 hours) versus long (≥97 hours) BIT showed no differences in rejection scores or time to first rejection.
- Analysis based on median BDI (12 hours) also revealed no significant differences in mortality or rejection.
Conclusions:
- Pre-transplantation time intervals, including BIT and BDI, do not appear to influence heart transplant (HT) mortality or rejection.
- These findings support a more flexible approach to HT organ allocation and potentially increase organ availability.
- Further research may explore other donor-specific factors influencing long-term HT success.
Aim:
We aimed to study the implications of pre-transplantation time intervals on HT outcomes.
Methods:
Brain injury time (BIT) was defined as the period from the donor brain injury to brain death declaration. Brain death interval (BDI) was defined as the period from brain death to application of an aortic cross-clamp during donor heart procurement. Allograft ischemia was defined as the time from donor aortic cross-clamp to aortic unclamping. End points included mortality and rejections.
Results:
Between 1997 and 2017, we assessed 173 patients. Kaplan-Meier analyses showed that prolonged donor BIT, BDI, allograft ischemia, and total injury time had no significant effect on mortality and rejections. Patients were subdivided into short BIT (<97 hours, n = 87) and long BIT (≥97 hours, n = 86) groups. No differences in rejection scores nor in time to first rejection were noted. Kaplan-Meier analysis showed a similar long-term survival in the two groups. Sub-analysis of both groups according to their median BDI (12 hours) revealed no differences in mortality or time to rejection.
Conclusions:
Pre-transplantation time intervals do not affect mortality or rejection. Our findings have important clinical implications regarding HT allocation and organ availability.
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