Rintaro Kinjo, Sooyun Caroline Tavolacci, Shazli Khan, Kenji Okumura, Junichi Shimamura, David Spielvogel, Suguru Ohira
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引用次数: 0
Abstract
Purpose
There are limited data regarding outcomes of a new heart allocation policy on recovering brain-death donors (DBD) from extended distances.
Methods
From May 6, 2014, to March 31, 2023, the United Network for Organ Sharing database was queried where 1885 cases (8.3%) out of 22 806 isolated heart transplants received donor hearts from extended distances (ED) greater than 500 miles. Patients were divided into groups based on the transplanted date before or after the policy change (October 18, 2018): old (N = 443) versus new (N = 1383). A total of 439 pairs were matched utilizing propensity score matching.
Results
The utilization of hearts from ED in the new system increased 2.7 times. Before matching, characteristics that differed included new group recipients with higher usage of temporary mechanical circulatory support devices and donors with more anoxia as the cause of death (new, 47% vs. old, 37%; p < 0.001). In the matched cohort, the incidences of dialysis (14% vs. 11%, p = 0.18), stroke (3.9% vs. 2.7%, p = 0.44), or pacemaker implantation (3.0% vs. 2.5%, p = 0.83) were similar. Both groups showed similar 1-year recipient survival (90.9% vs. 90.4%, p = 0.79) and graft survival (90.7% vs. 90.2%, p = 0.8).
Conclusion
In the new allocation policy, the utilization of hearts from ED has increased approximately three-fold compared to the period before the policy change without affecting transplant outcomes.
期刊介绍:
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.