Hemodynamic follow-up of cardiac allografts from poisoned donors
| Autor: | N. Mirow, Michael M. Koerner, Latif Arusoglu, Lech Hornik, Kazutomo Minami, Gero Tenderich, Benjamin Stuettgen, Reiner Koerfer, Stefan Wlost, H. Posival |
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| Rok vydání: | 1998 |
| Předmět: |
Inotrope
Tissue and Organ Procurement Heart disease Alkylphosphate medicine.medical_treatment Digitalis medicine Humans Transplantation Homologous Survival rate Heart transplantation Transplantation biology Carbon monoxide poisoning business.industry Poisoning Hemodynamics biology.organism_classification medicine.disease Tissue Donors Survival Rate Anesthesia Heart Transplantation business Follow-Up Studies |
| Zdroj: | Transplantation. 66(9) |
| ISSN: | 0041-1337 |
| Popis: | Background. The current shortage of donor organs, combined with an increasing demand for cardiac allografts, means that extended donor criteria are becoming more and more accepted. The use of cardiac allografts for transplantation from donors after acute poisoning is still under discussion; few data are currently available in the medical literature. We describe our experience with 19 orthotopic heart transplant recipients of organs from donors after acute intoxication with different agents. Methods. Between March 1989 and December 1997, 883 orthotopic heart transplantations were performed at our transplant unit. Within this group, we accepted donor hearts after ethanol intoxication (n=1), benzodiazepine (n=1), alkylphosphate (E 605) in combination with beta-blocker intoxication (n=1), carbon monoxide poisoning (n=5), digitalis (n=1), digitalis/glibenclamide (n=1), chlormethiazole (n=1), propoxyphene (n=1), alkylphosphate (E 605) (n=1), insulin (n=2), neprobamate/ thiocyacide/flurazepam (n=1), paracetamol (n=1), carbamazepine (n=1), and cyanide (n=1) intoxication. At the time of organ explantation, hemodynamic data were available from all patients. Results. Early mortality in this group was 11%; cumulative survival after 5 years was 74%. Conclusions. Based on our limited experience, cardiac allografts from donors exposed to different kinds of poisons can be transplanted in selected cases. If the donor organ is not hemodynamically compromised, showing regular filling pressures on low or mild inotropic support just before explantation, and if there are no electrocardiographic changes in combination with elevation of the transaminases, cardiac allograft transplantation seems to be a safe and life-saving procedure. |
| Databáze: | OpenAIRE |
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