Organ donation, recovery and ischemia-reperfusion injuryDonor Brain Death Time and Impact on Outcomes in Heart Transplantation
Section snippets
Methods
A review of prospectively collected data on all patients who underwent cardiac transplantation at our institution between June 2001 and March 2011 was performed. During this time 245 heart transplants were undertaken. Sixteen heterotopic and 14 heart lung transplants were excluded from this analysis leaving 215 patients who underwent orthotopic heart transplantation. Those 215 patients form the basis of this study. Survival data was censored on March 1, 2012. Data was collected on donor
Results
The demographics of the 215 patients who form the study cohort are outlined in Table 1. Univariate analysis of the variables associated with all cause mortality is shown in Table 2. Requirement for postoperative ECMO, preoperative creatinine, and donor age were most strongly associated with increased risk of death. Longer rejection-free period was associated with a reduced risk of death (Table 2). Brain death time was not associated with mortality, when assessed as a continuous variable or
Discussion
There are few recent studies investigating the impact of brain death time on outcomes in heart transplantation, and those that have been published report conflicting results. Despite having a larger cohort, we have been unable to replicate the findings of Odim et al of a correlation between longer brain death time and improved rejection free survival.3 In that study of pediatric recipients, Odim et al postulated that the longer brain death time allows resolution and attenuation of the
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