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Heterotopic Cervical Heart Transplantation in Mice
Published on: August 25, 2015
Heart Transplantation and Cold Ischemia: Towards Crossing the Border?
Elvis Aaron Porto1, Marcello Laneza Felicio1, Antônio Sérgio Martins1
1Universidade Estadual Paulista Faculdade de Medicina de Botucatu Hospital das Clínicas de Botucatu Botucatu São Paulo Brazil Departamento de Cirurgia e Ortopedia, Serviço de Cirurgia Cardiovascular e Transplante Cardíaco, Hospital das Clínicas de Botucatu, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil.
Insights
This study found no significant difference in 30-day mortality after heart transplantation between patients with cold ischemic times greater than 4 hours and those with shorter times. These findings may inform strategies to increase donor organ availability.
Area of Science:
- Cardiology
- Transplantation Surgery
- Organ Preservation
Background:
- Heart transplantation is vital for advanced heart failure treatment.
- Optimizing organ viability through acceptable cold ischemic times is critical for successful outcomes.
- This research examines the impact of prolonged cold ischemia on early mortality post-heart transplant.
Purpose of the Study:
- To investigate the association between cold ischemic time exceeding 4 hours and 30-day mortality following heart transplantation.
- To evaluate the safety and efficacy of using organs with extended cold ischemic periods.
Main Methods:
- A retrospective observational study analyzed medical records of heart transplant recipients from January 2019 to December 2023.
- Inclusion criteria specified the use of histidine-tryptophan-ketoglutarate preservation solution.
- Data collected included recipient demographics, heart failure etiology, procedural details, and 30-day mortality.
Main Results:
- The study included 62 heart transplant recipients (79% male, average age 51).
- Seven patients (≥ 4 hours cold ischemia) had a 43% 30-day mortality rate; 17 of 55 patients (< 4 hours) died (31%).
- Chi-square analysis showed no statistically significant difference in 30-day mortality based on cold ischemic time (P = 0.835).
Conclusions:
- No significant difference in 30-day mortality was observed between heart transplant recipients with cold ischemic times > 4 hours versus < 4 hours.
- These findings suggest potential for expanding donor pool utilization.
- Further strategies are needed to balance allograft availability with patient waiting lists.
Introduction:
Heart transplantation is a crucial therapeutic modality for patients with advanced heart failure. For satisfactory results, acceptable ischemic times are essential. This study aims to investigate the relationship between cold ischemic time > 4 hours and mortality in the first month after heart transplantation.
Methods:
Retrospective and observational analysis of medical records of patients who underwent heart transplantation between January 2019 and December 2023. The inclusion criteria were patients who underwent heart transplantation using the histidine-tryptophan-ketoglutarate preservation solution during organ retrieval and immediately before organ implantation. Recipient variables, etiology of heart failure, procedural variables, and 30-day mortality were studied.
Results:
During the study period, 62 patients underwent heart transplantation. There were a predominance of males (79%) and an average age of 51 years. Seven patients had a cold ischemic time ≥ 4 hours, with three dying (43%) before 30 days. Among the 55 patients with cold ischemic times < 4 hours, 17 died (31%) before 30 days. Statistical analysis using the chi-square test revealed no statistically significant association between cold ischemia and mortality in the first 30 days after transplantation (P = 0.835).
Conclusion:
The study found no difference in 30-day mortality between patients who underwent heart transplantation with cold ischemic times > 4 hours and those with cold ischemic times < 4 hours. Thus, there may be new strategies to increase the number of donors with a safe rebalance of the relationship between the number of available allografts and patients on the waiting list.
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