TITLE

Orthotopic heart transplantation with donors greater than or equal to 60 years of age: a single-center experience

AUTHOR(S)
Bruschi, Giuseppe; Colombo, Tiziano; Oliva, Fabrizio; Morici, Nuccia; Botta, Luca; Cannata, Aldo; Frigerio, Maria; Martinelli, Luigi
PUB. DATE
July 2011
SOURCE
European Journal of Cardio-Thoracic Surgery;Jul2011, Vol. 40 Issue 1, pe55
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objectives: Heart transplantation is the best therapeutic option for patients suffering from end-stage heart failure, but donor organ availability still represents a major problem. This had led to a shift toward extended donor criteria. The aim of the present study is to analyze the short- and long-term results of heart transplantation in patients with donor age ≥60 years. Methods: Since November 1985, 890 patients have been transplanted at our center. We consider, for the present study, only primary adult heart transplantations performed after 1990, totaling 761 patients, mean age at transplantation 49.8 years, and 616 patients being male (81%). We compare the short- and long-term results of patients transplanted with donors younger than 60 years or ≥60 years. Results: Since 1990, at our center, 711 patients have been heart transplanted with a donor younger than 60 years, while 50 patients received a heart from a donor older than 60 years. No differences have been reported in the etiology of cardiomyopathy, previous surgery, or mean ischemic time. Patients transplanted with donors ≥60 years of age were significantly older compared to the younger donors’ group. Donor cause of death was a cerebrovascular accident in 82% of donors ≥60 years versus 41% in younger donors. Patients’ heart transplanted with donors ≥60 years had a higher incidence of acute graft failure with a hospital mortality of 32% (16 patients) significantly higher compared with 10.2% for the other group. No differences were noticed in the incidence of renal failure, acute rejection treated, coronary allograft vasculopathy, and neoplasm during long-term follow-up. Conclusions: It was possible to expand the cardiac donor pool by accepting allografts from donors ≥60 years of age in selected cases by performing a coronary angiogram. A meticulous donor evaluation and a careful risk assessment between the risk of death on the waiting list and probable increased hospital mortality are needed.
ACCESSION #
61175266

 

Related Articles

  • Could you have saved my life? Levine, Hallie // Glamour;Mar2003, Vol. 101 Issue 3, p206 

    Relates experience of a familial dilated cardiomyopathy patient. Death of her mother from the same disease; Contribution of a heart transplant on the patient; Call for organ donors to save other people's lives.

  • Simultaneous heart and kidney transplantation from a single donor. Hsu, Ron-Bin; Tsai, Meng-Kun; Lee, Po-Huang; Lee, Chii-Ming; Chen, Ming-Fong; Wang, Shoei-Shen; Lin, Fang-Yue; Chu, Shu-Hsun // European Journal of Cardio-Thoracic Surgery;Dec2008, Vol. 34 Issue 6, p1179 

    Abstract: Objective: There are no guidelines to establish the indications and contraindications for a simultaneous heart and kidney transplantation. We report our single-institutional experience with simultaneous heart and kidney transplantation. Methods: Retrospective chart review. Results:...

  • Axial Flow Artificial Heart Blood Pumps: A Brief Review. Kafagy, Dhyaa; Gitano-Briggs, Horizon // Trends in Biomaterials & Artificial Organs;2013, Vol. 27 Issue 3, p124 

    The condition of patients with heart failure often declines even with optimal medical treatment. Heart transplantation has traditionally been the preferred treatment of such patients. The lack of donor organs motivated the development of the Total Artificial Heart in the early 60s and...

  • Medium-term outcome of recipients of marginal donor hearts selected with new stress-echocardiographic techniques over standard criteria. Bombardini, Tonino; Arpesella, Giorgio; Maccherini, Massimo; Procaccio, Francesco; Potena, Luciano; Bernazzali, Sonia; Leone, Ornella; Picano, Eugenio // Cardiovascular Ultrasound;2014, Vol. 12 Issue 1, p1 

    Background Heart transplantation is limited by severe donor organ shortage. Regardless of the changes made in the acceptance of marginal donors, any such mechanism cannot be considered successful unless recipient graft survival rates remain acceptable. A stress echo-driven selection of donors...

  • Ethical Guidelines for Organ Transplantation from Deceased Donors. MacDonald, Peter // Heart, Lung & Circulation;Jul2015, Vol. 24 Issue 7, p633 

    No abstract available.

  • Mechanical Circulatory Support for the Failing Heart – Progress, Pitfalls and Promises. Hayward, Christopher; Jansz, Paul // Heart, Lung & Circulation;Jun2015, Vol. 24 Issue 6, p527 

    No abstract available.

  • Maintenance of physiological coronary endothelial function after 3.3 h of hypothermic oxygen persufflation preservation and orthotopic transplantation of non-heart-beating donor hearts. H. Fischer, Jürgen; Funcke, Claudia; Yotsumoto, Goichi; Jeschkeit-Schubbert, Stephanie; Kuhn-Régnier, Ferdinand // European Journal of Cardio-Thoracic Surgery;Jan2004, Vol. 25 Issue 1, p98 

    Objective: The use of non-heart-beating donors (NHBD) might increase the number of grafts available for transplantation. Experiments on heart transplantation from NHBDs demonstrated the necessity for oxygenation during preservation to allow sufficient myocardial recovery. It has been shown that,...

  • The potential of cardiac allografts from donors after cardiac death at the University of Wisconsin Organ Procurement Organization Osaki, Satoru; Anderson, James E.; Johnson, Maryl R.; Edwards, Niloo M.; Kohmoto, Takushi // European Journal of Cardio-Thoracic Surgery;Jan2010, Vol. 37 Issue 1, p74 

    Abstract: Objective: The purpose of this study is to investigate the potential availability of hearts from adult donation after cardiac death (DCD) donors within an acceptable hypoxic period. Methods: We retrospectively reviewed a donor database from the University of Wisconsin Organ Procurement...

  • Procuración a distancia de corazón con fines de trasplante. Careaga-Reyna, Guillermo; Zetina-Tun, Hugo; Villaseñor-Colín, Cesar; Alvarez-Sánchez, Luis Manuel; Urías-Báez, Rafael; de la Cerda-Belmont, Gustavo Armando // Cirugia y Cirujanos;sep/oct2012, Vol. 80 Issue 5, p424 

    Background: the low availability of organ donors is a serious hindrance to heart transplantation. Long-distance organ procurement has been accepted as an option despite longer ischemic time for the heart. Methods: long-distance procurement from outside Mexico City in adult patients with terminal...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics