The role of donor age and ischemic time on survival following orthotopic heart transplantation

Rizzo, Dario F. Del; Menkis, Alan H.; Pflugfelder, Peter W.; Novick, Richard J.; McKenzie, Francine; Boyd, W. Douglas; Kostuk, William J.

doi:10.1016/s1053-2498(98)00059-x

Cited by 139 publications

(88 citation statements)

References 2 publications

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“…Advanced donor age has historically been associated with poor outcomes after transplantation, although the impact of donor age can vary by organ (19,20). In heart and kidney transplants, increased donor age is a risk factor for mortality and delayed graft function (21). Donor age affects both quality and longevity, and its effect on patient survival in kidney transplantation has been shown to be greater than that of the histocompatibility difference between donor and recipient (22).…”

Section: Impact Of Aging On the Donormentioning

confidence: 99%

Aging and the immune response to organ transplantation

Colvin¹,

Smith²,

Tullius³

et al. 2017

Journal of Clinical Investigation

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Section: Impact Of Aging On the Donormentioning

confidence: 99%

Aging and the immune response to organ transplantation

Colvin¹,

Smith²,

Tullius³

et al. 2017

Journal of Clinical Investigation

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“…All rights reserved. Ann Cardiothorac Surg 2018;7(1):106-117 www.annalscts.com of the donor heart is performed by our own surgeons, the direct communication between the procurement and the implanting team might help to significantly reduce ischemic times (15)(16)(17)(18). Also, most donors come from Belgian hospitals which results in short transportation times.…”

Section: Discussionmentioning

confidence: 99%

“…Until the end of 2015, 648 transplantations were performed in 615 patients, resulting in an average annual transplantation rate of 23 (range, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Thirty recipients received a second donor heart and one patient was transplanted three times.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

How to obtain and maintain favorable results after heart transplantation: keys to success?

Cleemput

Verbelen²,

Aelst

et al. 2018

Ann. Cardiothorac. Surg.

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We compared survival in our heart recipients with survival rates reported by the International Society of Heart and Lung Transplantation (ISHLT) Registry. As recipient and donor characteristics are changing over time, we studied four different eras. In order to differentiate between short-and long-term survival, we analyzed both overall survival and survival at one year. Obviously, this exercise is only relevant when baseline donor and recipient characteristics are comparable, as these differences may affect the outcome in opposite directions. To overcome this potential bias as much as possible, we calculated the Index for Mortality Prediction After Cardiac Transplantation (IMPACT)-scores and the Donor Risk Index (DRI). Looking to our results, we found that our DRIs in the different eras are almost equal to those obtained from the United Network for Organ Sharing database in the very same eras. Our IMPACT-scores, on the other hand, seem higher than those reported by ISHLT. Survival after transplantation and conditional on 1-year survival was higher than the outcome reported by the ISHLT Registry. As our operation technique and post-transplant immunosuppressive schedule did not differ from most centers, we speculated on potential factors that might contribute to our positive results. Patient selection and a relatively short waiting time are important contributors to the overall survival benefit. Our centralized follow-up may also have played an important role. Finally, the indefinite compulsory health insurance coverage in our country and easy access to different screening programs might also have influenced our outcome in a positive way. We are well aware that with challenges like donor organ shortage, more and more patients on mechanical circulatory support (MCS) will affect outcomes in the future.Keywords: Heart transplantation; predictors; survival Submitted Sep 11, 2017. Accepted for publication Nov 25, 2017Nov 25, . doi: 10.21037/acs.2017 View this article at: http://dx.doi.org/10. 21037/acs.2017.12.03 Perspective IntroductionComparing the results of hip surgery performed by one surgeon with the results of his colleague working in the hospital next door, is asking for trouble. Comparing results of one heart transplant center with those of another or, even more challenging, those of a registry, is at least as daunting.Nevertheless, it is worthwhile to critically review one's results and compare them with those of peers. In case they differ manifestly, one has to speculate on why this is the case considering the importance our society currently attributes to cost effectiveness and transparency. Of course, this exercise only makes sense when you are comparing apples with apples. You should first examine that you are transplanting the same types of patients and that you are using the same types of donors.We compared our short-and long-term survival data with those of the ISHLT registry. To do so, we also compared our recipient and donor risk profiles with those of the UNOS database. Finally, we speculated...

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“…Longer ischemic periods in cardiac transplantation, and higher morbidity and mortality have been evaluated (13). In cardiac transplantation the accepted time is 4 to 5 hours.…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nementioning

confidence: 99%

Acute Renal Failure and Its Impact on Survival Following Cardiac Transplantation

Sezer¹,

Yavuz²,

Canöz³

et al. 2016

Turk Neph Dial Transpl

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OBJectIVe: We evaluated the incidence and risk factors for acute renal failure (ARF) and also the associated hazard of death in recipients of cardiac transplants. MAterIAl and MetHODS:We included 25 patients in the study; 18 patients developed ARF (72%) and underwent continuous venovenous hemodiafiltration (Group I) and 7 patients had stable renal function (28%) (Group II). We retrospectively retrieved demographic variables; clinical, perioperative, postoperative complications and echocardiographic data; and biochemical parameters at the time of the surgery and six months later. reSultS:Cumulative survival was 72.2% after 6 months, 64.2% after 24 months, and 51.4% after 32 months for Group I and 50% after 32 months for Group II (p>0.05). A total of 8 patients died (32%); 1 (5.5%) from Group I and 7 (87.5%) from Group II. Risk factors for ARF were preoperative serum BUN, creatinine levels, and cardiopulmonary bypass time (p<0.05). Only one patient underwent chronic hemodialysis because of chronic renal dysfunction in Group I while there was no such patient in group II.cOncluSIOn: Preoperative serum BUN, creatinine value, and cardioopulmonary bypass time were found to be risk factors for ARF after cardiac transplantation. Postoperative renal dysfunction did not affect long-term renal function and survival.

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The role of donor age and ischemic time on survival following orthotopic heart transplantation

Cited by 139 publications

References 2 publications

Aging and the immune response to organ transplantation

Aging and the immune response to organ transplantation

How to obtain and maintain favorable results after heart transplantation: keys to success?

Acute Renal Failure and Its Impact on Survival Following Cardiac Transplantation

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