Extended criteria for cardiac allograft donors

Oakley, Ryan; Yonan, N.; Simpson, Brian; Campbell, Claire; Rahman, Ataur; Deiraniya, A K

doi:10.1016/0967-2109(95)94381-6

Cited by 16 publications

(19 citation statements)

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“…87 This has led to high numbers of donors refused by cardiac surgeons exclusively due to the doses of catecholamines used. 88 However, excellent outcomes have been reported in heart transplant recipients from donors managed with high doses of dopamine and norepinehrine 89 and, as discussed previously, restoring the loading conditions of the heart after loss of sympathetic tone is essential for maintaining and improving cardiac performance after brain death. Achieving an adequate coronary perfusion pressure is probably more important than avoiding high doses of catecholamines.…”

Section: Hemodynamic Managementmentioning

confidence: 94%

Brain death and its implications for management of the potential organ donor

Bugge

2009

Acta Anaesthesiol Scand

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The systemic physiologic changes that occur during and after brain death affect all organs suitable for transplantation. Major changes occur in the cardiovascular, pulmonary, endocrine, and immunological systems, and, if untreated may soon result in cardiovascular collapse and somatic death. Understanding these complex physiologic changes is mandatory for developing effective strategies for donor resuscitation and management in such a way that the functional integrity of potentially transplantable organs is maintained. This review elucidates these physiological changes and their consequences, and based on these consequences the rationale behind current medical management of brain-dead organ donors is discussed.

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Section: Hemodynamic Managementmentioning

confidence: 94%

Brain death and its implications for management of the potential organ donor

Bugge

2009

Acta Anaesthesiol Scand

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“…This stems from the large number of donors refused by cardiovascular surgeons, exclusively due to the use of high dose catecholamines during donor maintenance. A survey revealed that up to two thirds of cardiovascular surgeons would refuse a heart graft for implantation if doses of more than 10mcg kg (1 min (1 of dopamine were used in donor maintenance [37]. Some authors do not recommend the use of norepinephrine because of splanchnic vasoconstriction [38].…”

Section: Cardiovascular Managementmentioning

confidence: 98%

Management of the brainstem dead organ donor: Pathophysiology and donor optimization

Townley

2005

Clinical Intensive Care

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Transplantation of vital human organs is a life saving therapy for patients with end-stage organ failure. However, donor management remains one of the most neglected areas in transplantation medicine. Brainstem death leads to heamodynamic, metabolic and immune perturbations. Failure to provide adequate physiological support during this time accounts for at least 25% of lost donor organs. Donor optimization leads to increased organ procurement and contributes to improved organ function in the recipient. This article reviews the management of the brainstem dead donor from intensive care through organ procurement whilst highlighting advances and controversies in donor care.

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“…Предполагалось, что сердца от доноров старших возрастных категорий, или так называемых возрастных доноров, более склонны к повреждению во время смерти мозга, фармакохолодовой консервации и последующей реперфузии, что может привести к выраженной ранней дисфункции трансплантата [1,2]. Однако за последние десятилетия отношение к выполне нию ТС от возрастных доноров стало меняться, что связано с ростом количества пациентов с застойной сердечной недостаточностью, нуждающихся в ТС, нехваткой донорских сердец и высокой летальнос тью в листе ожидания [3].…”

Section: Introductionunclassified

Heart transplantation from older donors

Попцов

Спирина

Колоскова

et al. 2017

RJTAO

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ФГБУ «Федеральный научный центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, Москва, Российская Федерация В сложившейся ситуации дефицита донорских органов выполнение трансплантации сердца от так назы ваемых возрастных доноров является одним из реальных путей повышения доступности и увеличения количества пересадок сердца, прежде всего у потенциальных реципиентов, нуждающихся в неотложном ее выполнении. При подготовке и выполнении трансплантации сердца от возрастных доноров необходи мо учитывать повышенный риск развития ранней дисфункции сердечного трансплантата, наличия транс миссивного атеросклероза коронарных артерий, развития и прогрессирования васкулопатии сердечного трансплантата, что может негативно сказаться на ранней и отдаленной выживаемости реципиентов. При правильном подборе пары «донор-реципиент», эффективном разрешении ранней дисфункции сердеч ного трансплантата, своевременном применении лечебных мер, направленных на профилактику васку лопатии сердечного трансплантата, а также на коррекцию трансмиссивного атеросклероза коронарных артерий, ранние и отдаленные результаты трансплантации сердца от возрастных доноров сопоставимы с результатами трансплантации от доноров со стандартными критериями. Ключевые слова: сердечная недостаточность, трансплантация сердца.hearT TranSPlanTaTiOn frOM OlDer DOnOrS In the current situation of the shortage of suitable donor organs, heart transplantation from older donors is one of the ways to increase the performance of more heart transplants, particularly, in patients with urgent need of transplantation. While planning a heart transplantation from older donor one should consider increased risk of early cardiac allograft dysfunction, preexisting coronary artery disease, accelerated transplant vasculopathy which may adversely affect early and longterm survival of recipients. Subject to careful selection of donor-reci pient pairs, effective prevention and treatment of early cardiac allograft dysfunction, preexisting atherosclerosis and transplant vasculopathy the early and longterm survival of heart transplant recipients from older donors is comparable to heart transplantation from young donors.

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Extended criteria for cardiac allograft donors

Cited by 16 publications

References 0 publications

Brain death and its implications for management of the potential organ donor

Brain death and its implications for management of the potential organ donor

Management of the brainstem dead organ donor: Pathophysiology and donor optimization

Heart transplantation from older donors

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