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Successful long-term outcome with prolonged ischemic time cardiac allografts
E M Briganti1, P J Bergin, F L Rosenfeldt
1Heart and Lung Transplant Service, Alfred Hospital, Prahran, Melbourne, Australia.
Insights
Heart transplantation can be safely performed using donor hearts with extended preservation times. This practice increases donor availability without compromising patient survival or allograft function.
Area of Science:
- Cardiology
- Transplantation Immunology
- Surgical Innovation
Background:
- Limited availability of cardiac allografts restricts heart transplantation.
- Extended ischemic times for donor hearts can expand the donor pool.
Purpose of the Study:
- To evaluate the impact of prolonged allograft ischemic time on heart transplant outcomes.
- To assess the safety and efficacy of using donor hearts with extended preservation.
Main Methods:
- Compared short- and long-term outcomes in 150 heart transplant recipients.
- Grouped recipients based on allograft ischemic time: <241, 241-300, and >300 minutes.
Main Results:
- No significant differences in allograft function were observed across ischemic time groups.
- Transplant-associated coronary disease development and actuarial survival rates were similar.
- Prolonged ischemic time did not negatively affect short- or long-term outcomes.
Conclusions:
- Donor hearts with prolonged ischemic times can be safely utilized in heart transplantation.
- Expanded use of extended preservation allografts improves treatment options for heart failure patients.
- This approach does not introduce long-term risks for heart transplant recipients.
Background:
The limited availability of cardiac allografts together with the increasing number of patients on the waiting list restricts treatment of this population with heart transplantation. An increase in the available donor pool has been facilitated by the use of allografts with prolonged ischemic time (> 240 minutes).
Methods:
Short- and long-term outcomes were compared in 150 heart transplant recipients on the basis of allograft ischemic time (< 241 minutes, 241 to 300 minutes, and > 300 minutes).
Results:
No difference was found in allograft functional capacity, the development of transplant-associated coronary disease, or actuarial survival in the short and long term.
Conclusions:
Improved population treatment with prolonged ischemic time cardiac allografts can be safely undertaken without long-term risk to heart transplant recipients.