The Effect of Cardiac Preservation Solutions on Heart Transplant Survival

Autor: Jack G. Copeland, Seth T. Lirette, David A. Baran, Kristen T. Carter, Richard P. Cochran, Hannah Copeland, Anthony L. Panos, Lawrence L. Creswell
Rok vydání: 2018
Předmět:
Graft Rejection
Male
Adenosine
medicine.medical_treatment
Disaccharides
Potassium Chloride
chemistry.chemical_compound
Electrolytes
0302 clinical medicine
Glutamates
Insulin
Mannitol
Young adult
Saline
Cardioplegic Solutions
Graft Survival
Heart
Organ Preservation
Middle Aged
Allografts
Glutathione
Treatment Outcome
030220 oncology & carcinogenesis
Cardiology
030211 gastroenterology & hepatology
Female
Saline Solution
Adult
medicine.medical_specialty
Adolescent
Allopurinol
Organ Preservation Solutions
03 medical and health sciences
Young Adult
Raffinose
Internal medicine
medicine
Humans
Histidine
Survival analysis
Aged
Retrospective Studies
Heart Failure
Creatinine
Proportional hazards model
business.industry
Retrospective cohort study
Odds ratio
Survival Analysis
Glucose
chemistry
Ventricular assist device
Heart Transplantation
Surgery
business
Procaine
Follow-Up Studies
Zdroj: The Journal of surgical research. 242
ISSN: 1095-8673
Popis: Background Limited data exist that compare the predominant cardiac preservation solutions (CPSs). Materials and methods The United Network for Organ Sharing database was retrospectively reviewed from January 1, 2004 to March 31, 2018, for donor hearts. Of 34,614 potential donors, 21,908 remained after applying the exclusion criteria. The CPS analyzed included saline, the University of Wisconsin (UW), cardioplegia, Celsior, and Custodiol. The primary endpoints were recipient survival and posttransplant rejection. Logistic and Cox models were used to quantify survival endpoints. Results Saline was used as the CPS in 2549 patients (12%), UW in 10,549 (48%), cardioplegia in 1307 (6%), Celsior in 5081 (23%), and Custodiol in 2422 (11%). Donor age ranged from 15 to 68 y (mean = 32.0 y, median = 30.0 y), and 71% were male. Adjusted survival probabilities of recipients whose donor hearts were procured with saline was 96% 30 d, 90% 1 y, UW: 97% 30 d, 92% 1 y, cardioplegia: 95% 30 d, 87% 1 y, Celsior: 96% 30 d, 90% 1 y, and Custodiol: 97% 30 d, 92% 1 y. When these comparisons were adjusted for donor age, sex, ethnicity, ischemic time, recipient age, sex, ethnicity, creatinine, ventricular assist device (VAD), length of stay, region and days on waiting list, cardioplegia solution was demonstrated to have a higher risk of death (30 d, 1 y, overall) and posttransplant rejection versus UW (odds ratio 1.70, P = 0.001; odds ratio 1.63, P Conclusions Cardioplegia solutions for cardiac preservation are associated with a higher mortality in heart transplant recipients.
Databáze: OpenAIRE
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