Donor Heart Selection: Wythenshawe Experience
Autor: | Tarek Aziz, A. Machaal, R Shah, Nizar Yonan, N. Khasati, Mohamad N. Bittar |
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Rok vydání: | 2005 |
Předmět: |
medicine.medical_specialty
Time Factors Graft failure Ischemic time Risk Assessment Treatment Refusal medicine High doses Humans In patient Intensive care medicine Selection (genetic algorithm) Survival analysis Retrospective Studies Transplantation business.industry Patient Selection Hemodynamics Heart Retrospective cohort study Middle Aged Survival Analysis Tissue Donors Surgery Treatment Outcome Donor heart England Heart Transplantation business Follow-Up Studies |
Zdroj: | Transplantation Proceedings. 37:1331-1332 |
ISSN: | 0041-1345 |
DOI: | 10.1016/j.transproceed.2004.12.208 |
Popis: | BACKGROUND: The decline in the number of suitable donor hearts has led to an increasing interest in the use of previously unacceptable donors. This study aimed to evaluate the outcome of recipients of donor hearts considered medically unsuitable for transplantation at this center that were used in other centers in the United Kingdom. METHODS: Forty donor hearts (group 1) were declined by Wythenshawe Hospital and used in other units in the United Kingdom in the period extending from April 1998 to March 2003. One hundred four hearts (group 2) were transplanted at Wythenshawe Hospital during the same period. Donors and recipient data were obtained from the United Kingdom Cardiothoracic Transplant Audit database. Mortality in both groups was analyzed using SPSS software. RESULTS: Mortality in patients receiving grafts from group 1 donors was significantly higher than in group 2 (P < .0009). Of the early deaths in this group 50% (6 of 12) were the result of graft failure. These donors were receiving high doses of inotropes, had ischemic time exceeding 3.5 hours, and the grafts were transplanted into high-risk patients. CONCLUSION: Hearts declined on medical grounds by one center should be evaluated with caution before being considered suitable for transplantation, especially when more than one adverse factor is present. |
Databáze: | OpenAIRE |
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