Effects of Donor Pre-Treatment With Dopamine on Survival After Heart Transplantation
| Autor: | Amir K. Bigdeli, H. Welp, Paul T. Brinkkoetter, Achim Koch, Simone Hoeger, Peter Schnuelle, Jan Gummert, Duygu Doenmez, Uwe Gottmann, Johannes Boehm, Rainer Birck, Urs Benck, Andreas Zuckermann, Hans B. Lehmkuhl, Benito A. Yard, Matthias Karck, Stephan Hirt, Bernhard K. Krämer, Christoph Bara, Andreas O. Doesch, Detlef Boesebeck, Uwe Schulz, W. Lauchart, Thomas Strecker, M Berchtold-Herz, Florian Wagner, Hartmuth B. Bittner, Ulf Herold, Stefan Brose |
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| Rok vydání: | 2011 |
| Předmět: |
Heart transplantation
medicine.medical_specialty business.industry medicine.medical_treatment Hazard ratio medicine.disease law.invention Transplantation surgical procedures operative Randomized controlled trial law Ventricular assist device Multicenter trial Internal medicine Hemofiltration medicine Cardiology business Cardiology and Cardiovascular Medicine Kidney transplantation |
| Zdroj: | Journal of the American College of Cardiology. 58(17):1768-1777 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2011.05.060 |
| Popis: | Objectives We determined the outcome of cardiac allografts from multiorgan donors enrolled in a randomized trial of donor pre-treatment with dopamine. Background Treatment of the brain-dead donor with low-dose dopamine improves immediate graft function after kidney transplantation. Methods A cohort study of 93 heart transplants from 21 European centers was undertaken between March 2004 and August 2007. We assessed post-transplant left ventricular function (LVF), requirement of a left ventricular assist device (LVAD) or biventricular assist device (BVAD), need for hemofiltration, acute rejection, and survival of recipients of a dopamine-treated versus untreated graft. Results Donor dopamine was associated with improved survival 3 years after transplantation (87.0% vs. 67.8%, p = 0.03). Fewer recipients of a pre-treated graft required hemofiltration after transplant (21.7% vs. 40.4%, p = 0.05). Impaired LVF (15.2% vs. 21.3%, p = 0.59), requirement of a LVAD (4.4% vs. 10.6%, p = 0.44), and biopsy-proven acute rejection (19.6% vs. 14.9%, p = 0.59) were not statistically different between groups. Post-transplant impaired LVF (hazard ratio [HR]: 4.95; 95% confidence interval [CI]: 2.08 to 11.79; p Conclusions Treatment of brain-dead donors with dopamine of 4 μg/kg/min will not harm cardiac allografts but appears to improve the clinical course of the heart allograft recipient. (Prospective Randomized Trial to Evaluate the Efficacy of Donor Preconditioning With Dopamine on Initial Graft Function After Kidney Transplantation; NCT00115115) |
| Databáze: | OpenAIRE |
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