Low Incidence of Coronary Angiography in the Evaluation Process of the Potential Heart Donor

Schweiger, Martin; Klüber, J.; Bosch, Alessandra; Levinski, D. V.; Prenner, G.; Stiegler, P.; Sereinigg, Michael; Tscheliessnigg, Karlheinz; Iberer, F.; Wasler, A.

doi:10.1016/j.transproceed.2014.06.069

Cited by 4 publications

(7 citation statements)

References 16 publications

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“…This diagnostic tool allows to avoid any false‐positivity derived from coronary palpation whereas it easily detects any severe atherosclerotic lesions, defined as one or more major coronary vessels affected by a stenosis > 50 %; indeed, as recommended by ISHLT guidelines, such grafts should not be accepted for HTx, unless performing surgical revascularization at the time of implant [10,16]. Therefore, based on the present experience, our current protocol includes coronary angiography which we feel to suggest as routine procedure in all donors ≥ 40 years of age or in those with clear risk factors for CAD, as also supported by others [19,23].…”

Section: Discussionmentioning

confidence: 98%

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Influence of donor‐transmitted coronary artery disease on long‐term outcomes after heart transplantation ‐ a retrospective study

et al. 2020

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Background Cardiac allograft vasculopathy (CAV) is an important cause of late mortality after heart transplantation, which may be influenced by preexisting coronary disease (CAD) in the donor heart. Methods The aim of this study was to verify whether CAD in the donor heart had any influence on survival, cardiac‐related adverse events (CRAEs), and coronary disease progression after transplantation. Donor coronary angiography performed in 289 hearts showed absence of CAD in 232 (no‐CAD group) and moderate (≤50%) stenoses (CAD group) in 57. The 2 groups were compared for survival, freedom from CRAEs, and development of grade ≥ 2 CAV after transplantation. Results Of 30‐day mortality and postoperative complication rate was similar as mean follow‐up (76 ± 56 and 75 ± 55 months) for no‐CAD and CAD (P = 0.8). Ten‐year actuarial survival was 58 ± 4% and 62 ± 7% for no‐CAD and CAD (P = 0.4). Ten‐year freedom from grade ≥ 2 CAV and from CRAEs was 81 ± 4% and 66 ± 5% vs 75 ± 8% and 67 ± 9% in no‐CAD and CAD (P = 0.9 and 0.9, respectively). Conclusions Donor hearts with moderate CAD did not affect survival, freedom from CRAEs and did not accelerate development of high‐grade CAV after transplantation supporting the use of such grafts to expand the donor pool. Routine use of coronary angiography in donor selection appears justified.

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Section: Discussionmentioning

confidence: 98%

“…Schweigher et al. investigating the practice of coronary angiography in potential donor hearts found that this method was used in < 6% of donors evaluated at their institution [19]. These data led them to strongly recommend an implementation of angiographic studies to be an important part of the evaluation process of donor grafts.…”

Section: Discussionmentioning

confidence: 99%

Influence of donor‐transmitted coronary artery disease on long‐term outcomes after heart transplantation ‐ a retrospective study

et al. 2020

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“…As only 16 CAD grafts were used for transplantation, it was not possible to derive any conclusion regarding the outcomes of their recipients (≥50% mortality rate at one year in our cohort) who were certainly recipients with the highest risk profile. DTCA significantly worsens heart transplantation outcome [7,9,10]. Grafts with multiple vessel CAD are at serious risk of early graft failure, yet the short-and long-term prognosis of single vessel CAD hearts is not different from grafts without CAD, suggesting that these hearts may further increase the pool of available grafts [6].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, there is a greater risk for donortransmitted coronary atherosclerosis (DTCA), which may dramatically impact recipients' survival [6,7]. DTCA is a risk factor for primary graft dysfunction and seems to increase the risk of allograft vasculopathy, a major cause of morbi-mortality in heart transplant recipients [8][9][10][11]. Primary graft failure is mostly associated with older donor age and non-head trauma as donor cause of death, particularly in Europe [4,12].…”

Section: Introductionmentioning

confidence: 99%

Performing diagnostic coronary angiography to evaluate high-risk cardiac donors: A French nationwide cohort study

Ivanès

Cantrelle

Genet

et al. 2019

International Journal of Cardiology

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“…However, they tend to be older and have more comorbid conditions . As coronary artery disease is a major risk factor for poor heart transplantation outcome, it was suggested to perform donor CA more frequently to determine the presence of coronary disease . Moreover, the increasing availability of cardiac catheterization laboratories within hospitals might further increase the use of donor CA.…”

Section: Discussionmentioning

confidence: 99%

Impact of donor coronary angiography on kidney transplantation outcomes

Lesouhaitier

Legeai

Savoye

et al. 2018

Clinical Transplantation

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Coronary angiography (CA) is the gold standard evaluation of coronary artery disease in potential multi-organ donors. This use of iodinated contrast media could lead to contrast-induced acute kidney injury and consequently to delayed graft function (DGF). All patients in France who received a kidney from a 45-70-year-old donor without medical contraindication for cardiac donation and with at least one cardiovascular risk factor were included. Recipients of preemptive kidney transplant or multi-organ transplant, or who died within the first 8 days post-transplantation were excluded. Data were obtained from CRISTAL database. From March 2012 to June 2014, 892 kidneys from 483 donors were transplanted. DGF was reported in 38.9% of the 375 kidney recipients grafted with a kidney from the 217 donors who had CA and in 45.5% of the 440 kidney recipients who received a kidney from the 257 donors without CA. Multivariate analysis showed that CA or repeated injection of iodinated contrast media did not influence the risk of DGF. CA did not increase the risk of primary non-function, the duration of DGF or post-transplantation hospital stay and did not affect the graft function at 1 year. Evaluation of potential multi-organ donors with CA does not affect kidney graft outcomes.

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Low Incidence of Coronary Angiography in the Evaluation Process of the Potential Heart Donor

Cited by 4 publications

References 16 publications

Influence of donor‐transmitted coronary artery disease on long‐term outcomes after heart transplantation ‐ a retrospective study

Influence of donor‐transmitted coronary artery disease on long‐term outcomes after heart transplantation ‐ a retrospective study

Performing diagnostic coronary angiography to evaluate high-risk cardiac donors: A French nationwide cohort study

Impact of donor coronary angiography on kidney transplantation outcomes

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