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Effects of donor cause of death, ischemia time, inotrope exposure, troponin values, cardiopulmonary resuscitation, electrocardiographic and echocardiographic data on recipient outcomes: A review of the literature
Journal article   Peer reviewed

Effects of donor cause of death, ischemia time, inotrope exposure, troponin values, cardiopulmonary resuscitation, electrocardiographic and echocardiographic data on recipient outcomes: A review of the literature

Michael A McCulloch, Warren A Zuckerman, Thomas Möller, Kenneth Knecht, Kimberly Y Lin, Gary S Beasley, David M Peng, Dimpna C Albert, Oliver Miera, Anne I Dipchand, …
Pediatric transplantation, Vol.24(3), pp.e13676-n/a
05/2020
DOI: 10.1111/petr.13676
PMID: 32198808

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Abstract

Heart transplantation has become standard of care for pediatric patients with either end-stage heart failure or inoperable congenital heart defects. Despite increasing surgical complexity and overall volume, however, annual transplant rates remain largely unchanged. Data demonstrating pediatric donor heart refusal rates of 50% suggest optimizing donor utilization is critical. This review evaluated the impact of donor characteristics surrounding the time of death on pediatric heart transplant recipient outcomes. An extensive literature review was performed to identify articles focused on donor characteristics surrounding the time of death and their impact on pediatric heart transplant recipient outcomes. Potential pediatric heart transplant recipient institutions commonly receive data from seven different donor death-related categories with which to determine organ acceptance: cause of death, need for CPR, serum troponin, inotrope exposure, projected donor ischemia time, electrocardiographic, and echocardiographic results. Although DITs up to 8 hours have been reported with comparable recipient outcomes, most data support minimizing this period to <4 hours. CVA as a cause of death may be associated with decreased recipient survival but is rare in the pediatric population. Otherwise, however, in the setting of an acceptable donor heart with a normal echocardiogram, none of the other data categories surrounding donor death negatively impact pediatric heart transplant recipient survival. Echocardiographic evaluation is the most important donor clinical information following declaration of brain death provided to potential recipient institutions. Considering its relative importance, every effort should be made to allow direct image visualization.
Adolescent Biomarkers - blood Cardiopulmonary Resuscitation - methods Cardiotonic Agents - therapeutic use Cause of Death Child Child, Preschool Cold Ischemia - statistics & numerical data Donor Selection - methods Echocardiography Electrocardiography Heart Failure - diagnosis Heart Failure - drug therapy Heart Failure - mortality Heart Failure - surgery Heart Transplantation Humans Infant Infant, Newborn Risk Factors Tissue Donors Treatment Outcome Troponin - blood Warm Ischemia - statistics & numerical data

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