Single-center retrospective analysis of 125 donor hearts from brain death donation and to explore the use of marginal donor hearts_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 WU Min , WU Yijing , WU Meifen , MAI Mingjie , HUANG Jingsong , CHEN Oudi

Department of Cardiac Surgery, Guangdong Academy of Medical Sciences, Guangdong Provincial People’s Hospital, Guangdong Cardiovascular Institute, Guangzhou, 510080, P. R. China;

Corresponding author：

WU Min, Email: 26396284@qq.com

Keywords：

Heart transplantation; marginal donor heart; mitral regurgitation; tricuspid regurgitation; coronary calcification

DOI：

10.7507/1007-4848.201909078

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Objective To analyze the assessment and maintenance of 125 donor hearts from brain death donation and explore the use of marginal donor hearts.Methods A retrospective analysis was conducted on the evaluation, maintenance, operation and follow-up results of 125 donor hearts from April 2016 to August 2019. There were 98 males and 27 females at age of 6-50 (36.0±2.4) years.Results Twelve donor hearts were discarded due to unqualified evaluation after heart harvest. 113 patients of heart transplantation were performed with a double lumen venous anastomosis manner. The mean time of cold ischemia was 220.1±6.7 min. Four patients died within 30 days after operation. Postoperative right ventricular assist circulation was performed in 4 patients, intra-aortic balloon counterattack (IABP) in 12 patients and extracorporeal membrane oxygenation (ECMO) in 12 patients. Marginal donors included 15 hepatitis B antigen positive donor hearts, 2 tricuspid regurgitation, 1 mitral regurgitation, 5 coronary calcification, 4 myocardial stunning and 2 severe weight mismatch. The results of follow-up (2 years) after marginal donor heart transplantation were satisfactory.Conclusion Improving the assessment and maintenance of donor hearts can improve the utilization rate of the heart, and the marginal donor heart transplantation needs long-term follow-up.

Citation： WU Min, WU Yijing, WU Meifen, MAI Mingjie, HUANG Jingsong, CHEN Oudi. Single-center retrospective analysis of 125 donor hearts from brain death donation and to explore the use of marginal donor hearts. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(11): 1069-1073. doi: 10.7507/1007-4848.201909078 Copy

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1. Stehlik J, Kobashigawa J, Hunt SA, et al. Honoring 50 years of clinical heart transplantation in circulation: in-depth state-of-the-art review. Circulation, 2018, 137(1): 71-87.
2. 宿英英, 张叶红, 高岱佺, 等. 脑死亡判定标准与技术规范(成人质控版). 中华移植杂志(电子版), 2015, 9(1): 13-17.
3. 刘盛. 中国心脏移植供心获取与保护技术规范(2019版). 中华移植杂志(电子版), 2019, 13(1): 8-10.
4. Kumar L. Brain death and care of the organ donor. J Anaesthesiol Clin Pharmacol, 2016, 32(2): 146-152.
5. Wang H, Yang JF. Prevention and management of heart failure in China:past,present and future perspective. Zhonghua Xin Xue Guan Bing Za Zhi, 2019, 47(9): 714-7.
6. Jawitz OK, Raman V, Barac YD, et al. Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis. J Thorac Cardiovasc Surg, 2019: pii: S0022-5223(19)30959-6.
7. Angleitner P, Kaider A, Gokler J, et al. High-dose catecholamine donor support and outcomes after heart transplantation. J Heart Lung Transplant, 2018, 37(5): 596-603.
8. Kobashigawa J, Khush K, Colvin M, et al. Report from the American Society of Transplantation Conference on Donor Heart Selection in Adult Cardiac Transplantation in the United States. Am J Transplant, 2017, 17(10): 2559-2566.
9. Ram E, Lavee J, Kogan A, et al. Does donor-recipient age difference matter in outcome of heart transplantation? Clin Transplant, 2019: e13593.
10. Moayedi Y, Khush KK. Throwing out the good with the bad: Declining potential donor hearts with left ventricular dysfunction. J Heart Lung Transplant, 2018, 37(3): 321-322.
11. Huprikar S, Danziger-Isakov L, Ahn J, et al. Solid organ transplantation from hepatitis B virus-positive donors: consensus guidelines for recipient management. Am J Transplant, 2015, 15(5): 1162-72.
12. Horan JL, Stout JE, Alexander BD. Hepatitis B core antibody-positive donors in cardiac transplantation: a single-center experience. Transpl Infect Dis, 2014, 16(5): 859-863.
13. Bergenfeldt H, Stehlik J, Hoglund P, et al. Donor-recipient size matching and mortality in heart transplantation: Influence of body mass index and gender. J Heart Lung Transplant, 2017, 36(9): 940-947.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Single-center retrospective analysis of 125 donor hearts from brain death donation and to explore the use of marginal donor hearts

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