Effect of donor heart damage on survival after transplantation
| Autor: | P. G. I. Stovin, T. A. H. English, F. C. Wells, S. Darracott-Cankovic, D. R. Wheeldon, John Wallwork |
|---|---|
| Rok vydání: | 1989 |
| Předmět: |
Graft Rejection
Pulmonary and Respiratory Medicine Cardiac function curve medicine.medical_specialty Biopsy Cause of Death Internal medicine medicine Humans Prospective Studies Prospective cohort study Heart Failure Tissue Survival Physiological function Birefringence medicine.diagnostic_test business.industry Myocardium Average analysis General Medicine Myocardial function Surgery Survival Rate Transplantation Donor heart Cardiology Heart Transplantation Tissue Preservation Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 3:525-532 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/1010-7940(89)90113-9 |
| Popis: | Evaluation of the functional condition of the heart prior to its removal from the donor or after transport to the recipient is difficult. Biopsies of the myocardium allow serial assessments to be made throughout this period, but suffer from the disadvantage that the average analysis of biopsies has only a tenuous connection with physiological function. Quantitative birefringence measurements (QBM), on the other hand, assess the ability of myocardial fibres to respond to ATP and calcium and have been shown to correlate well with measurements of cardiac function (P less than 0.001). A prospective study of myocardial biopsies before excision, after transport and again after transplantation, using quantitative birefringence measurement of biopsies of the heart has recently been completed. These studies have shown evidence of impaired myocardial function in 73 (43%) of 172 donor hearts studied prior to excision, with a further 27% showing significant deterioration during storage and transport to the recipient. Biopsy assessments therefore indicated that at the moment of implantation, only 30% of the donor hearts were normal. Functional assessment of the biopsies by QBM correlated with early clinical outcome of transplantation (P less than 0.001). Longer term follow-up of the recipients (up to 5 years) has shown that the mortality of recipients of hearts with impaired function before transplantation is significantly increased (44% of 120) compared with that of recipients of undamaged hearts (6% of 52, P less than 0.001). |
| Databáze: | OpenAIRE |
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