Impact of Donor High-Risk Social Behaviors on Recipient Survival in Cardiac Transplantation

Xu, David S.; Hartman, Deanna; Ludrosky, Kristin; Campbell, James W.; Starling, Randall C.; Taylor, David O.; Smedira, Nicholas G.; González-Stawinski, Gonzalo V.

doi:10.1097/tp.0b013e3181ca56e0

Cited by 23 publications

(25 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This lack of consensus around using the heart in cocaine-related deaths is, despite numerous case reports of their use and several published observational studies, showing long-term positive outcomes following their use [7][8][9]. In a study of 997 cardiac transplants undertaken in a single transplantation centre, the impact of "high-risk" social behaviours (defined as previous incarcerations, non-professional tattoos/piercing, habitual substance abuse, practice of an alternative lifestyle and HIV/hepatitis infection) found in 143 donors on recipient survival was studied [7]. There was no difference in mean recipient survival between those donors without high-risk social behaviours (10.6 years) compared to those with (10.4 years).…”

Section: Discussionmentioning

confidence: 86%

Using Drug-Intoxicated Deaths as Potential Organ Donors: Impression of Attendees at the American College of Medical Toxicology 2014 Annual Scientific Meeting

Wood

Chan

2014

J. Med. Toxicol.

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 86%

Using Drug-Intoxicated Deaths as Potential Organ Donors: Impression of Attendees at the American College of Medical Toxicology 2014 Annual Scientific Meeting

Wood

Chan

2014

J. Med. Toxicol.

View full text Add to dashboard Cite

show abstract

“…In August 2005, the Canadian Blood Services decreased the deferral period for tattooing and ear or body piercing from 12 to 6 months. [112] 2. [110] Currently, the American Red Cross does not require a deferral for blood donation if the body piercing was performed using sterile instruments or single-use equipment.…”

Section: Blood Blood Product and Organ Donationmentioning

confidence: 99%

Body Piercing

Holbrook

Minocha

Laumann

2012

American Journal of Clinical Dermatology

View full text Add to dashboard Cite

Body and earlobe piercing are common practices in the USA today. Minor complications including infection and bleeding occur frequently and, although rare, major complications have been reported. Healthcare professionals should be cognizant of the medical consequences of body piercing. Complications vary depending on the body-piercing site, materials used, experience of the practitioner, hygiene regimens, and aftercare by the recipient. Localized infections are common. Systemic infections such as viral hepatitis and toxic shock syndrome and distant infections such as endocarditis and brain abscesses have been reported. Other general complications include allergic contact dermatitis (e.g. from nickel or latex), bleeding, scarring and keloid formation, nerve damage, and interference with medical procedures such as intubation and blood/organ donation. Site-specific complications have been reported. Oral piercings may lead to difficulty speaking and eating, excessive salivation, and dental problems. Oral and nasal piercings may be aspirated or become embedded, requiring surgical removal. Piercing tracts in the ear, nipple, and navel are prone to tearing. Galactorrhea may be caused by stimulation from a nipple piercing. Genital piercings may lead to infertility secondary to infection, and obstruction of the urethra secondary to scar formation. In men, priapism and fistula formation may occur. Women who are pregnant or breastfeeding and have a piercing or are considering obtaining one need to be aware of the rare complications that may affect them or their child. Though not a 'complication' per se, many studies have reported body piercing as a marker for high-risk behavior, psychopathologic symptoms, and anti-social personality traits. When it comes to piercing complications, prevention is the key. Body piercers should take a complete medical and social history to identify conditions that may predispose an individual to complications, and candidates should choose a qualified practitioner to perform their piercing. As body piercing continues to be popular, understanding the risks of the procedures as well as the medical and psychosocial implications of wearing piercing jewelry is important for the medical practitioner.

show abstract

“…Several studies to date have evaluated specific donor characteristics including age (4, 6), cause of death (7, 8), sex mismatch (9), social risk factors (10, 11), medical history (12, 13), hemodynamic support requirements (14, 15), and their impact on post-transplant recipient survival. However, many of these studies were single-center reports with small sample sizes and evaluated only a limited number of donor variables.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Donor Risk Factors Predictive of Short-Term Heart Transplant Recipient Mortality: An Analysis of the United Network for Organ Sharing Database

Sorabella

Guglielmetti

Kantor

et al. 2015

Transplantation Proceedings

View full text Add to dashboard Cite

Background To address the shortage of donor hearts for transplant, there is significant interest in liberalizing donor acceptance criteria. Therefore, the aim of this study is to evaluate cardiac donor characteristics from the United Network for Organ Sharing (UNOS) database to determine their impact on post-transplant recipient outcomes. Methods Adult (≥ 18 years) patients undergoing heart transplant from July 1, 2004 to December 31, 2012 in the UNOS Standard Transplant Analysis and Research (STAR) database were reviewed. Patients were stratified by 1-year post-transplant status; survivors (Group S, n=13,643) and patients who died or underwent cardiac re-transplant at 1-year follow-up (Group NS/R=1,785). Thirty-three specific donor variables were collected for each recipient, and independent donor predictors of recipient death or re-transplant at 1 year were determined using multivariable logistic regression analysis. Results Overall 1-year survival for the entire cohort was 88.4%. Mean donor age was 31.5 ± 11.9 years and 72% were male. On multivariable logistic regression analysis, donor age > 40 years (OR 1.44, 95% CI 1.27-1.64), graft ischemic time > 3 hours (OR 1.32, 1.16-1.51), and the use of cardioplege (OR 1.17, 1.01-1.35) or Celsior (OR 1.21, 1.06-1.38) preservative solution were significant predictors of recipient death or re-transplant at 1 year post-transplant. Male donor gender (OR 0.83, 0.74-0.93) and the use of antihypertensives (OR 0.88, 0.77-1.00) or insulin (OR 0.84, 0.76-0.94) were protective from adverse outcomes at 1-year. Conclusions These data suggest that donors who are older, female, or have a long projected ischemic time pose greater risk to heart transplant recipients in the short-term. Additionally, certain components of donor management protocols, including antihypertensive and insulin administration, may be protective to recipients.

show abstract

Impact of Donor High-Risk Social Behaviors on Recipient Survival in Cardiac Transplantation

Cited by 23 publications

References 15 publications

Using Drug-Intoxicated Deaths as Potential Organ Donors: Impression of Attendees at the American College of Medical Toxicology 2014 Annual Scientific Meeting

Using Drug-Intoxicated Deaths as Potential Organ Donors: Impression of Attendees at the American College of Medical Toxicology 2014 Annual Scientific Meeting

Body Piercing

Cardiac Donor Risk Factors Predictive of Short-Term Heart Transplant Recipient Mortality: An Analysis of the United Network for Organ Sharing Database

Contact Info

Product

Resources

About