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Extended criteria for cardiac allograft donors: a consensus study
R M el Oakley1, N A Yonan, B M Simpson
1Department of Cardiac Surgery, Royal Brompton Hospital, London, United Kingdom.
Summary
Extending donor age to 55 years and accepting donors with certain medical histories can increase the number of available hearts for transplantation. Certain conditions remain exclusion criteria for cardiac allograft donation.
Area of Science:
- Cardiology
- Transplant Surgery
- Organ Donation
Background:
- Current criteria for referring potential cardiac allograft donors are established.
- Extending these criteria may increase donor availability.
Purpose of the Study:
- To achieve consensus on extending criteria for potential cardiac allograft donors.
- To identify factors that may or may not prohibit cardiac allograft donation.
Main Methods:
- A detailed questionnaire was sent to heart transplant surgeons in the United Kingdom.
- Surgeons' opinions were collected regarding donor selection criteria.
Main Results:
- Majority of surgeons support extending donor age to 55, even without coronary angiogram or echocardiogram.
- Certain conditions like family history of heart disease, hyperlipidemia, smoking, and specific causes of brain death were not prohibitive.
- Significant Q waves, hepatitis C antibodies, high pulmonary capillary wedge pressure, and need for inotropic support were exclusion criteria.
- Donor hormonal resuscitation and invasive monitoring were deemed unnecessary by most.
Conclusions:
- Increasing donor age to 55 can expand the pool of potential cardiac allograft donors.
- Brain death from paracetamol or barbiturate overdose should not necessarily prohibit organ donation.