BACKGROUND: Alternate waiting list strategies have been promoted as a means to offer the benefit of heart transplantation to a greater number of candidates. We undertook the current study to evaluate our experience with transplantation in alternate list (AL) candidates. METHODS: Adults undergoing heart transplantation from January 1, 2001, through April 15, 2004, were evaluated. Selected patients who did not meet criteria for standard listing for heart transplantation were offered alternate listing. Primary posttransplant outcomes included 30-day, 90-day, and more than 90-day mortality, and determinants of perioperative morbidity. RESULTS: Thirty-seven patients (14.3%) met alternate list criteria. Among these alternate list patients, contraindications to standard listing included age greater than 65 years, amyloidosis, severe diabetes mellitus and peripheral vascular disease, human immunodeficiency virus, and high-risk retransplant. The average age of alternate list donors was 41.2 +/- 13.9 years. Survival analysis revealed no posttransplant survival advantage for standard list recipients However, mean ventilatory support time was significantly (p < 0.001) longer in the alternate list group (5.7 +/- 9.3 days) compared with the standard group (2.3 +/- 4.2 days), and significantly more sternal wound infections (p = 0.03) were observed in the alternate list group (6 [16.2%]) compared with the standard group (13 [5.9%]). CONCLUSIONS: The alternate list patients demonstrated comparable survival with standard list patients, but did exhibit more ventilatory dependence and sternal wound infections. More than half of alternate list donor organs in the future could be considered for standard list candidates as well. Use of the alternate list reinforces the assertion that, even today, our donor criteria remain too stringent.
BACKGROUND: Alternate waiting list strategies have been promoted as a means to offer the benefit of heart transplantation to a greater number of candidates. We undertook the current study to evaluate our experience with transplantation in alternate list (AL) candidates. METHODS: Adults undergoing heart transplantation from January 1, 2001, through April 15, 2004, were evaluated. Selected patients who did not meet criteria for standard listing for heart transplantation were offered alternate listing. Primary posttransplant outcomes included 30-day, 90-day, and more than 90-day mortality, and determinants of perioperative morbidity. RESULTS: Thirty-seven patients (14.3%) met alternate list criteria. Among these alternate list patients, contraindications to standard listing included age greater than 65 years, amyloidosis, severe diabetes mellitus and peripheral vascular disease, human immunodeficiency virus, and high-risk retransplant. The average age of alternate list donors was 41.2 +/- 13.9 years. Survival analysis revealed no posttransplant survival advantage for standard list recipients However, mean ventilatory support time was significantly (p < 0.001) longer in the alternate list group (5.7 +/- 9.3 days) compared with the standard group (2.3 +/- 4.2 days), and significantly more sternal wound infections (p = 0.03) were observed in the alternate list group (6 [16.2%]) compared with the standard group (13 [5.9%]). CONCLUSIONS: The alternate list patients demonstrated comparable survival with standard list patients, but did exhibit more ventilatory dependence and sternal wound infections. More than half of alternate list donor organs in the future could be considered for standard list candidates as well. Use of the alternate list reinforces the assertion that, even today, our donor criteria remain too stringent.
Authors: Mark J Russo; Alexander Iribarne; Kimberly N Hong; Ryan R Davies; Steve Xydas; Hiroo Takayama; Ali Ibrahimiye; Annetine C Gelijns; Matthew D Bacchetta; Frank D'Ovidio; Selim Arcasoy; Joshua R Sonett Journal: Chest Date: 2009-10-09 Impact factor: 9.410
Authors: Kimberly N Hong; Alexander Iribarne; Berhane Worku; Hiroo Takayama; Annetine C Gelijns; Yoshifumi Naka; Val Jeevanandam; Mark J Russo Journal: Ann Thorac Surg Date: 2011-06-17 Impact factor: 4.330
Authors: Scott R Auerbach; Marc E Richmond; Jonathan M Chen; Ralph S Mosca; Jan M Quaegebeur; Linda J Addonizio; Daphne T Hsu; Jacqueline M Lamour Journal: Pediatr Cardiol Date: 2011-09-04 Impact factor: 1.655
Authors: Mark J Russo; Ryan R Davies; Kimberly N Hong; Alexander Iribarne; Steven Kawut; Matthew Bacchetta; Frank D'Ovidio; Selim Arcasoy; Joshua R Sonett Journal: J Thorac Cardiovasc Surg Date: 2009-11 Impact factor: 5.209
Authors: Mark J Russo; Ryan R Davies; Kimberly N Hong; Jonathan M Chen; Michael Argenziano; Alan Moskowitz; Deborah D Ascheim; Isaac George; Allan S Stewart; Mathew Williams; Annetine Gelijns; Yoshifumi Naka Journal: Ann Thorac Surg Date: 2009-04 Impact factor: 4.330
Authors: P Christian Schulze; Jeffrey Jiang; Jonathan Yang; Faisal H Cheema; Kenneth Schaeffle; Tomoko S Kato; Maryjane Farr; Susan Restaino; Mario Deng; Mathew Maurer; Evelyn Horn; Farhana Latif; Paolo C Colombo; Ulrich Jorde; Nir Uriel; Jennifer Haythe; Rachel Bijou; Ron Drusin; Sun Hi Lee; Hiroo Takayama; Yoshifumi Naka; Donna M Mancini Journal: Circ Heart Fail Date: 2013-03-15 Impact factor: 8.790
Authors: Marc D Samsky; Chetan B Patel; Ashleigh Owen; Phillip J Schulte; Jacob Jentzer; Paul B Rosenberg; G Michael Felker; Carmelo A Milano; Adrian F Hernandez; Joseph G Rogers Journal: Circ Heart Fail Date: 2013-10-02 Impact factor: 8.790