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Heart donation: the New Zealand experience, 1987-1996
P N Ruygrok1, R Maddison, J M Langlands
1Department of Cardiology, Green Lane Hospital, Auckland.
Insights
A 9-year audit of 267 donor hearts found only 28% were implanted. Increasing the recipient pool and public awareness are key to improving heart transplant rates.
Area of Science:
- Cardiology
- Transplantation Surgery
- Public Health
Background:
- Heart transplantation is a life-saving procedure for end-stage heart failure.
- Donor organ availability remains a significant limitation in heart transplantation programs worldwide.
Purpose of the Study:
- To audit donor hearts offered to a specific unit over a nine-year period.
- To assess the outcomes of donor heart utilization.
- To identify factors influencing heart acceptance rates and inform acceptance criteria.
Main Methods:
- Retrospective analysis of demographic, clinical, and outcome data for all referred donor hearts.
- Data collection included donor characteristics and reasons for heart non-implantation.
Main Results:
- 267 donor hearts were offered between 1987-1996; 76 (28%) were implanted.
- Primary reasons for non-implantation included lack of a suitable recipient (51%), medical unsuitability (20%), and donor age (19%).
- Donor demographics showed a mean age of 31.2 years, with trauma being the most common cause of death (52%).
Conclusions:
- Improving heart transplant rates requires addressing both donor organ supply and recipient availability.
- Strategies to increase the recipient pool and enhance public awareness of organ donation benefits are crucial.
Aims:
To audit all donor hearts offered to our unit, assess the outcome, identify factors which might enhance the acceptance rate and provide data on which to base and modify acceptance criteria.
Methods:
Demographic, clinical and outcome data were collected retrospectively and analysed for all patients in whom brain death had been established and permission for organ donation obtained from the family prior to referral to the transplant donor coordinator.
Results:
Over a nine year period (1987-96) 267 hearts were offered for transplantation. The mean donor age was 31.2 years (2-72), 163 being male and 104 female. The cause of death was secondary to trauma in 52%, neurological in 44% and due to hypoxia in 4%. The mean donor weight was 68 kg and the distribution of ABO blood group similar to the New Zealand population. Seventy-six hearts (28%) were implanted. Of the 191 not implanted no suitable recipient was available for 98 (51%) according to blood group and body weight criteria, 38 donors (20%) were medically unsuitable, 37 (19%) were declined because of donor age, 16 (8%) because of a markedly abnormal echocardiogram and 2 (1%) for logistical reasons.
Conclusions:
Enhanced efforts are needed to increase public awareness of the benefits of organ donation. However, a greater number of heart transplants may be achieved by increasing the recipient pool.