Antonella Galeone1, Shaida Varnous2, Guillaume Lebreton2, Eleodoro Barreda2, Sara Hariri3, Alain Pavie2, Pascal Leprince2. 1. Department of Thoracic and Cardiovascular Surgery, University Pierre et Marie Curie, Paris 6, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. Electronic address: a.galeone@email.it. 2. Department of Thoracic and Cardiovascular Surgery, University Pierre et Marie Curie, Paris 6, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. 3. Department of Anesthesiology, University Pierre et Marie Curie, Paris 6, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Abstract
OBJECTIVE: To evaluate the influence of cardiac arrest-resuscitated donors (CARDs) on the outcome of heart recipients. METHODS: Patients transplanted between July 2004 and December 2012 were divided into 2 groups according to the history of cardiac arrest in donors and their clinical records were retrospectively reviewed. RESULTS: A total of 584 heart transplantations were performed during the study period, and 117 recipients received an organ from a CARD. There were no differences between the 2 groups with regards to recipient age, sex, cardiomyopathy, preoperative extracorporeal membrane oxygenation, national high emergency waiting list, and redo surgery. Donors who sustained a cardiac arrest were significantly younger (44 [32-51] vs 49 [41-56] years; P < .001), their main cause of death was anoxia (57% vs 1%; P < .001), and they had significantly greater troponin T peak levels (0.51 [0.128-3.108] vs 0.11 [0.04-0.43] ng/mL; P < .001). Median cardiac arrest duration was 15 minutes (5-25). No difference was noted in donors with regards to left ventricular ejection fraction at time of organ procurement (62% ± 8% vs 63% ± 8%; P = .2). There were no differences between the 2 groups with regards to ischemic time (179 ± 60 vs 183 ± 59 minutes; P = .43), need for postoperative extracorporeal membrane oxygenation for primary graft failure (31% vs 30%; P = .993) and 30-days mortality. Recipients receiving an organ from a CARD had a significantly better 10 year survival (69.4% vs 50.4%; P = .017). CONCLUSIONS: History of cardiac arrest in donors with a preserved left ventricular ejection fraction at time of organ procurement doesn't affect outcome of heart recipients. Copyright Â
OBJECTIVE: To evaluate the influence of cardiac arrest-resuscitated donors (CARDs) on the outcome of heart recipients. METHODS:Patients transplanted between July 2004 and December 2012 were divided into 2 groups according to the history of cardiac arrest in donors and their clinical records were retrospectively reviewed. RESULTS: A total of 584 heart transplantations were performed during the study period, and 117 recipients received an organ from a CARD. There were no differences between the 2 groups with regards to recipient age, sex, cardiomyopathy, preoperative extracorporeal membrane oxygenation, national high emergency waiting list, and redo surgery. Donors who sustained a cardiac arrest were significantly younger (44 [32-51] vs 49 [41-56] years; P < .001), their main cause of death was anoxia (57% vs 1%; P < .001), and they had significantly greater troponin T peak levels (0.51 [0.128-3.108] vs 0.11 [0.04-0.43] ng/mL; P < .001). Median cardiac arrest duration was 15 minutes (5-25). No difference was noted in donors with regards to left ventricular ejection fraction at time of organ procurement (62% ± 8% vs 63% ± 8%; P = .2). There were no differences between the 2 groups with regards to ischemic time (179 ± 60 vs 183 ± 59 minutes; P = .43), need for postoperative extracorporeal membrane oxygenation for primary graft failure (31% vs 30%; P = .993) and 30-days mortality. Recipients receiving an organ from a CARD had a significantly better 10 year survival (69.4% vs 50.4%; P = .017). CONCLUSIONS: History of cardiac arrest in donors with a preserved left ventricular ejection fraction at time of organ procurement doesn't affect outcome of heart recipients. Copyright Â
Authors: Sebastian Roth; René M'Pembele; Anthony Nucaro; Alexandra Stroda; Theresa Tenge; Giovanna Lurati Buse; Stephan U Sixt; Ralf Westenfeld; Philipp Rellecke; Igor Tudorache; Markus W Hollmann; Hug Aubin; Payam Akhyari; Artur Lichtenberg; Ragnar Huhn; Udo Boeken Journal: J Clin Med Date: 2022-07-03 Impact factor: 4.964
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