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Impact of high-dose inotropic donor support on early myocardial necrosis and outcomes in cardiac transplantation.
- Source :
-
Clinical transplantation [Clin Transplant] 2012 Mar-Apr; Vol. 26 (2), pp. 322-7. Date of Electronic Publication: 2011 Oct 10. - Publication Year :
- 2012
-
Abstract
- Background: Cardiac donors routinely require vasoactive agents for circulatory stability after brain death. Nevertheless, inotropes have been associated with direct cardiac toxicity. Our study evaluated whether the use of high-dose inotropic support in potential donors was associated with increased early myocardial necrosis (MN) and worse clinical outcomes after cardiac transplantation.<br />Methods: The UTAH Cardiac Transplant Program (UCTP) and Intermountain Donor Services databases were queried for records between 1996 and 2009. The high-dose donor inotropic support (HDIS) group was defined as patients on dopamine >10 μg/kg/min. The incidence of early MN, intensive care unit (ICU) length of stay, length of ventilator support, and mortality was evaluated.<br />Results: Two hundred and forty-four recipients undergoing transplant met study criteria. The average donor age was 27 yr. The incidence of MN in the HDIS (n=29) and non-HDIS (n=204) groups was 14.8% and 6.7%, respectively, OR 2.67. Total ischemic time, ventilator support time, ICU stay, and actuarial survival were similar between both groups.<br />Conclusion: The use of high-dose inotropic support to maintain donor stability appears to have a higher trend for early post-transplant MN without an impact on clinical outcomes. With the current growing shortage of organ donors, it appears reasonable to use donors on high-dose inotropic support.<br /> (© 2011 John Wiley & Sons A/S.)
- Subjects :
- Adolescent
Adult
Brain Death physiopathology
Child
Child, Preschool
Female
Humans
Male
Middle Aged
Necrosis
Young Adult
Cardiotonic Agents administration & dosage
Cardiotonic Agents adverse effects
Dopamine administration & dosage
Dopamine adverse effects
Heart drug effects
Heart Transplantation adverse effects
Myocardium pathology
Postoperative Complications chemically induced
Tissue Donors
Tissue and Organ Harvesting
Subjects
Details
- Language :
- English
- ISSN :
- 1399-0012
- Volume :
- 26
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Clinical transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 21981698
- Full Text :
- https://doi.org/10.1111/j.1399-0012.2011.01504.x