Donor heart selection and outcomes: An analysis of over 2,000 cases

Aliabadi-Zuckermann, Arezu; Gökler, Johannes; Kaider, Alexandra; Riebandt, Julia; Moayedifar, R.; Osorio, Emilio; Haberl, T.; Angleitner, Philipp; Laufer, Günther; Forsythe, John; Kneževič, Ivan; Škorić, Boško; Erasmus, Michiel E.; Cleemput, Johan Van; Çalışkan, Kadir; Jonge, Nicolaas de; Szepes, Zoltán; Prodán, Zsolt; Wasler, A.; Bara, Christoph; Udovičić, Mario; Sandhaus, T.; Garbade, Jens; Ruhparwar, Arjang; Schoenrath, Felix; Hirt, Stephan; Antretter, Herwig; Schulz, Uwe; Richter, Manfred; Thul, Josef; Barten, Markus J.; Haneya, Assad; Aleksić, Ivan; Eifert, Sandra; Berchtold‐Herz, Michael; Smits, Jacqueline M.; Zuckermann, Andreas

doi:10.1016/j.healun.2018.04.014

Cited by 15 publications

(15 citation statements)

References 14 publications

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“…21,22 Perioperative complications and 30-day mortality showed no differences between the two groups. On the one hand, this might show that those organs are not inferior to the regular allocated ones as mentioned by Aliabadi-Zuckermann et al 15 Morbidity and mortality at 1-year follow-up after heart transplantation (transplanted with HU status and regular allocation: HU group; without HU status and rescue allocation: elective group.) Fig.…”

Section: Discussionmentioning

confidence: 87%

Use of Organs for Heart Transplantation after Rescue Allocation: Comparison of Outcome with Regular Allocated High Urgent Recipients

Immohr

Boeken

Mehdiani

et al. 2020

Thorac Cardiovasc Surg

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Background The number of patients waiting for heart transplantation (HTx) is exceeding the number of actual transplants. Subsequently, waiting times are increasing. One possible solution may be an increased acceptance of organs after rescue allocation. These organs had been rejected by at least three consecutive transplant centers due to medical reasons. Methods Between October 2010 and July 2019, a total of 139 patients underwent HTx in our department. Seventy (50.4%) of the 139 patients were transplanted with high urgency (HU) status and regular allocation (HU group); the remaining received organs without HU listing after rescue allocation (elective group, n = 69). Results Donor parameters were comparable between the groups. Thirty-day mortality was comparable between HU patients (11.4%) and rescue allocation (12.1%). Primary graft dysfunction with extracorporeal life support occurred in 26.9% of the elective group with rescue allocated organs, which was not inferior to the regular allocated organs (HU group: 35.7%). No significant differences were observed regarding the incidence of common perioperative complications as well as morbidity and mortality during 1-year follow-up. Conclusions Our data support the use of hearts after rescue allocation for elective transplantation of patients without HU status. We could show that patients with rescue allocated organs showed no significant disadvantages in the early perioperative morbidity and mortality as well at 1-year follow-up.

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Section: Discussionmentioning

confidence: 87%

Use of Organs for Heart Transplantation after Rescue Allocation: Comparison of Outcome with Regular Allocated High Urgent Recipients

Immohr

Boeken

Mehdiani

et al. 2020

Thorac Cardiovasc Surg

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“…Based on previous literature, we identified key candidate and donor characteristics to consider, as summarized in Tables and . Categorical characteristics that had missing values or were coded as “unknown” were grouped together and treated as “unknown.”…”

Section: Methodsmentioning

confidence: 99%

“…Prior work by our group and others has identified predictors of donor heart nonacceptance for transplantation in various cohorts . Of great interest, however, was the observation that many of these donor characteristics did not necessarily portend increased recipient mortality after transplantation, suggesting that these donor risk factors are not absolute contraindications to transplantation.…”

Section: Introductionmentioning

confidence: 99%

Great variability in donor heart acceptance practices across the United States

Khush

Ball

2020

American Journal of Transplantation

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Disparities in organ acceptance practices exacerbate donor heart nonuse and lead to increased waiting times and mortality for heart transplant candidates. We studied disparities in donor heart acceptance among US transplant centers and their relations to posttransplant outcomes. Candidate, potential transplant recipient match run, and deceased donor data were obtained from the United Network for Organ Sharing. We analyzed donor, candidate, and transplant center characteristics with respect to organ acceptance, offer acceptance, number of offers before acceptance (organ sequence number), and association with posttransplant mortality. A total of 693 420 donor heart offers made between April 2007 and December 2015 were included. We identified great variability in donor heart acceptance practices among US heart transplant centers. We identified donor and recipient characteristics that were strongly associated with heart organ and offer acceptance, and organ sequence number, and identified inconsistencies among centers with respect to how these characteristics influenced acceptance decisions. Finally, we identified characteristics that were highly predictive of donor heart nonuse and were not associated with increased recipient mortality, which may guide future efforts aimed at increasing use of available hearts for transplantation.

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“…Hypernatremia >145 mmol/L has been associated with an increased risk of death in patients with severe TBI . In another retrospective analysis of >2000 cases of donor heart, 75 (5%) were rejected by the Medical University of Vienna due to donor hypernatremia; 31 (41%) were later accepted elsewhere, and after transplantation survival rates were 71%, 62%, and 46% at 30 days, 1 and 3 years, respectively. Compared to other parameters, donor hypernatremia appears to contribute to poor outcomes .…”

Section: Introductionmentioning

confidence: 99%

“…In another retrospective analysis of >2000 cases of donor heart, 75 (5%) were rejected by the Medical University of Vienna due to donor hypernatremia; 31 (41%) were later accepted elsewhere, and after transplantation survival rates were 71%, 62%, and 46% at 30 days, 1 and 3 years, respectively. Compared to other parameters, donor hypernatremia appears to contribute to poor outcomes . This constitutes one of the few single‐center analyses in the literature concerning donor hypernatremia and HT outcome.…”

Section: Introductionmentioning

confidence: 99%

Donor hypernatremia and smoking addiction contribute to primary graft failure in heart transplantation

Finger

Cipullo

Neto

et al. 2019

Clinical Transplantation

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Introduction: Primary graft failure (PGF) is an important contributor to early mortality, accounting for 41% of deaths within the first 30 days after heart transplantation (HT). Donor hypernatremia has been associated with PGF development. However, controversial data exist regarding the impact of sodium deregulation in patient survival after HT. This study aimed to assess the influence of donor hypernatremia on PGF development and to determine the serum sodium level threshold to assist in decision-making for organ procurement. Methods:The medical record from 200 HT patients and organ donors were retrospectively assessed and categorized by PGF occurrence. Donor sodium levels were compared and cut-off points obtained by receiver operating characteristic (ROC) curve. A multiple logistic regression model was applied to assess the effects of factors and covariates that influence PGF development.Results: Sodium levels of donors were significantly higher in recipients who developed PGF than those who did not develop PGF (162 vs. 153 mmol/L, P = .001). The sodium cut-off value determined by the ROC curve was 159 mmol/L. The group who received organs from donors with a serum sodium concentration ≥159 mmol/L had a higher incidence of PGF (63.3% vs 32.4%, P < .001). Furthermore, donor sodium levels ≥159 mmol/L increased the likelihood of recipients developing PGF by 3.4 times. It is also observed that the incidence of donor smoking addiction was significantly higher in the PGF group (28.6% vs. 11.5%, P = .004) and donor smoking addiction increased the risk of developing PGF by 2.8 times. Conclusion:Smoking addiction and the application of suboptimal organs from donors with hypernatremia contribute to primary graft failure in heart transplantation. K E Y W O R D Sgraft survival, heart transplantation, hypernatremia, organ donors, primary graft dysfunction

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Donor heart selection and outcomes: An analysis of over 2,000 cases

Cited by 15 publications

References 14 publications

Use of Organs for Heart Transplantation after Rescue Allocation: Comparison of Outcome with Regular Allocated High Urgent Recipients

Use of Organs for Heart Transplantation after Rescue Allocation: Comparison of Outcome with Regular Allocated High Urgent Recipients

Great variability in donor heart acceptance practices across the United States

Donor hypernatremia and smoking addiction contribute to primary graft failure in heart transplantation

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