Primary Graft Failure After Heart Transplantation: The Importance of Donor Pharmacological Management

D’Ancona, Giuseppe; Santise, Gianluca; Falletta, Calogero; Pirone, Francesco; Sciacca, Sergio; Turrisi, Marco; Biondo, Domenico; Pilato, Michele

doi:10.1016/j.transproceed.2010.03.027

Cited by 45 publications

(28 citation statements)

References 7 publications

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“…Several authors have reported that donor heart dysfunction as evidenced by a low left ventricular ejection fraction on echocardiography, unstable donor haemodynamics, or the need for high doses of catecholamines is a potent risk factor for PGF [2, 3, 6, 11]. Historically, donor hearts that displayed these characteristics would have been regarded as unsuitable for transplantation; however, increased demand for transplantation has led to many Transplant Units including our own making use of these “marginal” hearts [3, 6, 11, 14].…”

Section: Risk Factors For Pgfmentioning

confidence: 99%

“…Historically, donor hearts that displayed these characteristics would have been regarded as unsuitable for transplantation; however, increased demand for transplantation has led to many Transplant Units including our own making use of these “marginal” hearts [3, 6, 11, 14]. The expectation is that the myocardial dysfunction evident in the donor is a result of stunning and is recoverable over time despite the current lack of a useful clinical measure that can reliably distinguish reversible from irreversible myocardial dysfunction in the brain dead donor.…”

Section: Risk Factors For Pgfmentioning

confidence: 99%

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Primary Graft Failure after Heart Transplantation

Iyer

Kumarasinghe

Hicks

et al. 2011

Journal of Transplantation

116

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Primary graft failure (PGF) is a devastating complication that occurs in the immediate postoperative period following heart transplantation. It manifests as severe ventricular dysfunction of the donor graft and carries significant mortality and morbidity. In the last decade, advances in pharmacological treatment and mechanical circulatory support have improved the outlook for heart transplant recipients who develop this complication. Despite these advances in treatment, PGF is still the leading cause of death in the first 30 days after transplantation. In today's climate of significant organ shortages and growing waiting lists, transplant units worldwide have increasingly utilised “marginal donors” to try and bridge the gap between “supply and demand.” One of the costs of this strategy has been an increased incidence of PGF. As the threat of PGF increases, the challenges of predicting and preventing its occurrence, as well as the identification of more effective treatment modalities, are vital areas of active research and development.

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Section: Risk Factors For Pgfmentioning

confidence: 99%

Section: Risk Factors For Pgfmentioning

confidence: 99%

Primary Graft Failure after Heart Transplantation

Iyer

Kumarasinghe

Hicks

et al. 2011

Journal of Transplantation

116

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“…This study demonstrated two novel findings; first, we showed that donor age is the predictor of early low output after HTx. Other factors that were considered to be risk factors for PGD, such as use of high dose chatecholamine [8,19], donor-recipient sex mismatch [7], ischemic time of donor heart [6], and small donor heart [9] were not significantly related to early low output after HTx. Second, we showed that early low output did not influence mid-term hemodynamic deterioration.…”

Section: Discussionmentioning

confidence: 94%

Donor age is a predictor of early low output after heart transplantation

Fujino

Kinugawa

Nitta

et al. 2016

Journal of Cardiology

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“…Nonetheless, the reported risk factors can be divided into 3 categories. From the aspect of donors, the factors included older age (>30 years old), cardiac dysfunction from cardiac echo, necessity of high-dose inotropic agents support [12,13], cause of brain death, duration from brain death to operation, and primary graft dysfunction of other organs. In terms of the recipients, the factors included older age (>60 years old), ventilator dependency, inotropic dependency, mechanical circulatory support, pulmonary hypertension, being overweight, and diabetes mellitus.…”

Section: Risk Factorsmentioning

confidence: 99%