Abstract
The aim of this study was to test the impact of donor and recipient characteristics on the development of primary graft failure (PGF) after heart transplantation (HT) by focusing on the donor's inotropic support. Heart donors and matched recipients data were prospectively collected. Univariate and multivariate analyses were used to determine independent predictors for PGF and peri-operative mortality. The donor's high inotrope requirement was defined as sustained need for dopamine exceeding 10 μg/kg/min and/or alpha agonists exceeding 0.06 μg/kg/min. PGF instead was defined as need for immediate post-HT mechanical circulatory support. Since 2006, we have performed 37 HTs. PGF occurred in six patients (16.2%). Although four patients (66.6%) were weaned off circulatory support, two of them (33.3%) died on mechanical assistance. Total in-hospital mortality was 10.8% (4/37). Upon multivariate analysis, pre-harvesting donor high inotrope dosage was the major determinant for PGF (P=0.03, OR=10.8). Given the organ shortage, many centers accepted marginal hearts assuming the donor's pre-harvest hemodynamic managing has a reduced impact on PGF development. As PGF remains the most lethal postoperative complication, the hazards should be carefully considered when using pre-harvesting high inotrope infusion rates.
| Original language | English |
|---|---|
| Pages (from-to) | 476-479 |
| Number of pages | 4 |
| Journal | Interactive Cardiovascular and Thoracic Surgery |
| Volume | 9 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 2009 |
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Keywords
- Heart transplant
- Primary graft failure
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
- Surgery
Cite this
Donor pharmacological hemodynamic support is associated with primary graft failure in human heart transplantation. / Santise, Gianluca; D'Ancona, Giuseppe; Falletta, Calogero; Pirone, Francesco; Sciacca, Sergio; Turrisi, Marco; Biondo, Domenico; Pilato, Michele.
In: Interactive Cardiovascular and Thoracic Surgery, Vol. 9, No. 3, 09.2009, p. 476-479.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Donor pharmacological hemodynamic support is associated with primary graft failure in human heart transplantation
AU - Santise, Gianluca
AU - D'Ancona, Giuseppe
AU - Falletta, Calogero
AU - Pirone, Francesco
AU - Sciacca, Sergio
AU - Turrisi, Marco
AU - Biondo, Domenico
AU - Pilato, Michele
PY - 2009/9
Y1 - 2009/9
N2 - The aim of this study was to test the impact of donor and recipient characteristics on the development of primary graft failure (PGF) after heart transplantation (HT) by focusing on the donor's inotropic support. Heart donors and matched recipients data were prospectively collected. Univariate and multivariate analyses were used to determine independent predictors for PGF and peri-operative mortality. The donor's high inotrope requirement was defined as sustained need for dopamine exceeding 10 μg/kg/min and/or alpha agonists exceeding 0.06 μg/kg/min. PGF instead was defined as need for immediate post-HT mechanical circulatory support. Since 2006, we have performed 37 HTs. PGF occurred in six patients (16.2%). Although four patients (66.6%) were weaned off circulatory support, two of them (33.3%) died on mechanical assistance. Total in-hospital mortality was 10.8% (4/37). Upon multivariate analysis, pre-harvesting donor high inotrope dosage was the major determinant for PGF (P=0.03, OR=10.8). Given the organ shortage, many centers accepted marginal hearts assuming the donor's pre-harvest hemodynamic managing has a reduced impact on PGF development. As PGF remains the most lethal postoperative complication, the hazards should be carefully considered when using pre-harvesting high inotrope infusion rates.
AB - The aim of this study was to test the impact of donor and recipient characteristics on the development of primary graft failure (PGF) after heart transplantation (HT) by focusing on the donor's inotropic support. Heart donors and matched recipients data were prospectively collected. Univariate and multivariate analyses were used to determine independent predictors for PGF and peri-operative mortality. The donor's high inotrope requirement was defined as sustained need for dopamine exceeding 10 μg/kg/min and/or alpha agonists exceeding 0.06 μg/kg/min. PGF instead was defined as need for immediate post-HT mechanical circulatory support. Since 2006, we have performed 37 HTs. PGF occurred in six patients (16.2%). Although four patients (66.6%) were weaned off circulatory support, two of them (33.3%) died on mechanical assistance. Total in-hospital mortality was 10.8% (4/37). Upon multivariate analysis, pre-harvesting donor high inotrope dosage was the major determinant for PGF (P=0.03, OR=10.8). Given the organ shortage, many centers accepted marginal hearts assuming the donor's pre-harvest hemodynamic managing has a reduced impact on PGF development. As PGF remains the most lethal postoperative complication, the hazards should be carefully considered when using pre-harvesting high inotrope infusion rates.
KW - Heart transplant
KW - Primary graft failure
UR - http://www.scopus.com/inward/record.url?scp=69249099700&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=69249099700&partnerID=8YFLogxK
U2 - 10.1510/icvts.2009.202085
DO - 10.1510/icvts.2009.202085
M3 - Article
C2 - 19564203
AN - SCOPUS:69249099700
VL - 9
SP - 476
EP - 479
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
SN - 1569-9293
IS - 3
ER -