Heart transplantation from donors with left ventricular ejection fraction under forty percent.
donor criteria
heart transplantation
left ventricle
reduced left ventricular ejection fraction
Journal
Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
16
04
2021
received:
01
01
2021
accepted:
26
04
2021
pubmed:
6
5
2021
medline:
23
7
2021
entrez:
5
5
2021
Statut:
ppublish
Résumé
Heart transplantation (HTx) remains the treatment of choice for patients with end-stage advanced heart failure. In 2016, the Shumakov National Medical Research Center commenced performing HTx from donors with abnormal left ventricular systolic function (LVEF < 40%). The aim of this study was to evaluate early and late outcomes of recipients after HTx from donors with abnormal LV systolic function. Four hundred eighty seven patients underwent HTx in our institution from January 2016 to December 2018. 27 (5.5%) patients were transplanted using cardiac allografts from donors with LVEF <40%. A total of 47 donors with LVEF <40% were evaluated for potential donation. Most heart donors revealed a left ventricular ejection fraction ranging between 30% and 40%. Twenty-five recipients required urgent HTx. Four recipients presented with early allograft dysfunction. All surviving recipients demonstrated early (85.2%) or delayed (14.8%) recovery of systolic function (LVEF > 60%). The use of dysfunctional donor hearts with impaired LV systolic function may be a realistic approach for expanding the donor pool. However, organs from such donors should be used for recipient cohorts requiring an urgent HTx, particularly for those with pretransplant mechanical circulatory support allowing for hemodynamic support in cases of early graft dysfunction in the post-transplant period.
Sections du résumé
BACKGROUND
Heart transplantation (HTx) remains the treatment of choice for patients with end-stage advanced heart failure. In 2016, the Shumakov National Medical Research Center commenced performing HTx from donors with abnormal left ventricular systolic function (LVEF < 40%). The aim of this study was to evaluate early and late outcomes of recipients after HTx from donors with abnormal LV systolic function.
METHODS
Four hundred eighty seven patients underwent HTx in our institution from January 2016 to December 2018. 27 (5.5%) patients were transplanted using cardiac allografts from donors with LVEF <40%.
RESULTS
A total of 47 donors with LVEF <40% were evaluated for potential donation. Most heart donors revealed a left ventricular ejection fraction ranging between 30% and 40%. Twenty-five recipients required urgent HTx. Four recipients presented with early allograft dysfunction. All surviving recipients demonstrated early (85.2%) or delayed (14.8%) recovery of systolic function (LVEF > 60%).
CONCLUSION
The use of dysfunctional donor hearts with impaired LV systolic function may be a realistic approach for expanding the donor pool. However, organs from such donors should be used for recipient cohorts requiring an urgent HTx, particularly for those with pretransplant mechanical circulatory support allowing for hemodynamic support in cases of early graft dysfunction in the post-transplant period.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14341Informations de copyright
© 2021 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd.
Références
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