Cardiac allografts from high-risk donors

Excellent clinical results

Gary Y. Ott, Ray E. Herschberger, Ranae R. Ratkovec, Douglas Norman, Jeffrey D. Hosenpud, Adnan Cobanoglu

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Rising waiting list mortality and increasing demand for donor organs have led to extension of traditionally accepted criteria for evaluation of cardiac grafts. From December 1985 to June 1992, 188 cardiac grafts were orthotopically transplanted into 178 recipients. Of these grafts, 38.3% ( 72 188) were defined as high-risk donors. Risk criteria included prolonged cardiopulmonary resuscitation, age greater than 40 years, high inotrope requirements, undersizing by more than 20% body weight, significant wall motion impairment by echocardiography, elevation of myocardial enzyme levels, and cold ischemia time greater than 4 hours. There were no recipient deaths attributable to primary graft failure in the perioperative period. Operative (30-day), 1-year and 5-year survival was 95.5%, 86.1%, and 77.3%, respectively, in the high-risk group compared with 93.7%, 86.0%, and 67.2%, respectively, in the low-risk donor cohort(p = 0.94). Comparison of duration of postoperative inotrope use, intensive care unit stay, total hospital stay, and in-hospital costs revealed no significant trends favoring either group in postoperative morbidity. Among long-term survivors, development of graft coronary disease was noted in 47.1% ( 24 51) of the high-risk donor group and only 17.4% ( 12 69) of the remaining group (p = 0.0005). Left ventricular ejection fractions in the high risk donor group were 0.58 ± 0.01 at 2 years. Review of this series suggests that selective use of apparently compromised cardiac donors is compatible with excellent cardiac function and survival. Higher incidence of graft vasculopathy may cause significant morbidity during late follow-up.

Original languageEnglish (US)
Pages (from-to)76-82
Number of pages7
JournalThe Annals of Thoracic Surgery
Volume57
Issue number1
DOIs
StatePublished - 1994

Fingerprint

Allografts
Tissue Donors
Transplants
Morbidity
Cold Ischemia
Perioperative Period
Waiting Lists
Survival
Hospital Costs
Cardiopulmonary Resuscitation
Stroke Volume
Coronary Disease
Intensive Care Units
Survivors
Echocardiography
Length of Stay
Body Weight
Mortality
Incidence
Enzymes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Ott, G. Y., Herschberger, R. E., Ratkovec, R. R., Norman, D., Hosenpud, J. D., & Cobanoglu, A. (1994). Cardiac allografts from high-risk donors: Excellent clinical results. The Annals of Thoracic Surgery, 57(1), 76-82. https://doi.org/10.1016/0003-4975(94)90368-9

Cardiac allografts from high-risk donors : Excellent clinical results. / Ott, Gary Y.; Herschberger, Ray E.; Ratkovec, Ranae R.; Norman, Douglas; Hosenpud, Jeffrey D.; Cobanoglu, Adnan.

In: The Annals of Thoracic Surgery, Vol. 57, No. 1, 1994, p. 76-82.

Research output: Contribution to journalArticle

Ott, GY, Herschberger, RE, Ratkovec, RR, Norman, D, Hosenpud, JD & Cobanoglu, A 1994, 'Cardiac allografts from high-risk donors: Excellent clinical results', The Annals of Thoracic Surgery, vol. 57, no. 1, pp. 76-82. https://doi.org/10.1016/0003-4975(94)90368-9
Ott, Gary Y. ; Herschberger, Ray E. ; Ratkovec, Ranae R. ; Norman, Douglas ; Hosenpud, Jeffrey D. ; Cobanoglu, Adnan. / Cardiac allografts from high-risk donors : Excellent clinical results. In: The Annals of Thoracic Surgery. 1994 ; Vol. 57, No. 1. pp. 76-82.
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