- 作者：Arun K. Singhal ; John D. Abrams ; Jun Mohara ; Richard D. Hasz ; Howard M. Nathan ; Carol A. Fisher ; Satoshi Furukawa and Bruce I. Goldman
- 刊名：The Journal of Heart and Lung Transplantation
- 出版年：2005
- 期刊代码：161_10532498
- 类别：med
- 出版时间：2005
- 卷：24
- 期：10
- 页码：1657-1664
- 文件大小：164 K
Background
Organ availability limits use of heart transplantation for treatment for end-stage heart disease. Hearts are currently obtained from donors declared brain dead (heart-beating donors [HBDs]). Although use of hearts from non–heart-beating donors (NHBDs) could reduce the shortage, they are considered unusable because of possible peri-mortem ischemic injury.Methods
To project how use of NHBD hearts could increase heart donation, we retrospectively reviewed donor databases from the Gift of Life Donor Program (GLDP), our local organ procurement organization, from 2001 through 2003. We screened the NHBD population using conservative donor criteria, assuming an acceptable hypoxic/ischemic time (time from withdrawal of care to cross-clamp) of 30 minutes.
Results
During the study period, there were 894 HBDs, 334 heart transplants and 119 NHBDs. NHBDs were similar to HBDs with respect to gender and ethnicity, but NHBDs were proportionately younger. Of 119 NHBDs, 55 did not meet the age criteria (≤45 years) and 20 were eliminated because of incomplete data. Eighty-two NHBDs were cross-clamped within 30 minutes of care withdrawal. Twenty NHBDs met all cardiac donor criteria, and 14 of these 20 had hypoxic/ischemic times ≤30 minutes. Pro rata estimation for the 20 NHBDs with incomplete data suggested 7 potential additional donors.
Conclusions
Based on our assumptions, 12%to 18%of NHBDs in the study period (14 to 21 of 119 total) were potential heart donors, representing a 4%to 6%increase over of the number of heart transplants performed during the same time interval.