The Effect of Cardiac Preservation Solutions on Heart Transplant Survival

Kristen T. Carter; Seth T. Lirette; David A. Baran; Lawrence L. Creswell; Anthony L. Panos; Richard P. Cochran; Jack G. Copeland; Hannah Copeland

doi:10.1016/j.jss.2019.04.041

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The Effect of Cardiac Preservation Solutions on Heart Transplant Survival

Journal article

Open access

Peer reviewed

The Effect of Cardiac Preservation Solutions on Heart Transplant Survival

Kristen T. Carter, Seth T. Lirette, David A. Baran, Lawrence L. Creswell, Anthony L. Panos, Richard P. Cochran, Jack G. Copeland and Hannah Copeland

The Journal of surgical research, Vol.242, pp.157-165

10/2019

DOI: 10.1016/j.jss.2019.04.041

PMID: 31078900

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Abstract

Limited data exist that compare the predominant cardiac preservation solutions (CPSs). The United Network for Organ Sharing database was retrospectively reviewed from January 1, 2004 to March 31, 2018, for donor hearts. Of 34,614 potential donors, 21,908 remained after applying the exclusion criteria. The CPS analyzed included saline, the University of Wisconsin (UW), cardioplegia, Celsior, and Custodiol. The primary endpoints were recipient survival and posttransplant rejection. Logistic and Cox models were used to quantify survival endpoints. Saline was used as the CPS in 2549 patients (12%), UW in 10,549 (48%), cardioplegia in 1307 (6%), Celsior in 5081 (23%), and Custodiol in 2422 (11%). Donor age ranged from 15 to 68 y (mean = 32.0 y, median = 30.0 y), and 71% were male. Adjusted survival probabilities of recipients whose donor hearts were procured with saline was 96% 30 d, 90% 1 y, UW: 97% 30 d, 92% 1 y, cardioplegia: 95% 30 d, 87% 1 y, Celsior: 96% 30 d, 90% 1 y, and Custodiol: 97% 30 d, 92% 1 y. When these comparisons were adjusted for donor age, sex, ethnicity, ischemic time, recipient age, sex, ethnicity, creatinine, ventricular assist device (VAD), length of stay, region and days on waiting list, cardioplegia solution was demonstrated to have a higher risk of death (30 d, 1 y, overall) and posttransplant rejection versus UW (odds ratio 1.70, P = 0.001; odds ratio 1.63, P < 0.001; hazard ratio 1.22, P < 0.001; hazard ratio 1.21, P < 0.001, respectively). Cardioplegia solutions for cardiac preservation are associated with a higher mortality in heart transplant recipients.

Heart transplant

Preservation solution

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Details

Title: Subtitle: The Effect of Cardiac Preservation Solutions on Heart Transplant Survival
Creators: Kristen T. Carter - University of Mississippi Medical Center
Seth T. Lirette - University of Mississippi Medical Center
David A. Baran - Sentara Heart Hospital
Lawrence L. Creswell - University of Mississippi Medical Center
Anthony L. Panos - University of Mississippi Medical Center
Richard P. Cochran - University of Mississippi Medical Center
Jack G. Copeland - University of Arizona
Hannah Copeland - Sentara Heart Hospital
Resource Type: Journal article
Publication Details: The Journal of surgical research, Vol.242, pp.157-165
Publisher: Elsevier Inc
DOI: 10.1016/j.jss.2019.04.041
PMID: 31078900
ISSN: 0022-4804
eISSN: 1095-8673
Grant note: DOI: 10.13039/100000002, name: NIH, award: T32 HL-105324; name: Mississippi Center for Clinical and Translational Research; DOI: 10.13039/100000057, name: National Institute of General Medical Sciences; DOI: 10.13039/100000002, name: National Institutes of Health, award: 5U54GM115428; DOI: 10.13039/100000057, name: National Institutes of General Medical Sciences; DOI: 10.13039/100000002, name: National Institutes of Health, award: 1U54GM115428
Language: English
Date published: 10/2019
Academic Unit: Cardiothoracic Surgery
Record Identifier: 9984322806302771

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