Performing diagnostic coronary angiography to evaluate high-risk cardiac donors: A French nationwide cohort study

Ivanès, Fabrice; Cantrelle, C.; Genet, Thibaud; Feuvre, Claude Le; Legeai, Camille; Jasseron, Carine; Pipien, I.; Epailly, Éric; Bastien, Olivier; Angoulvant, Denis; Dorent, Richard

doi:10.1016/j.ijcard.2018.08.003

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…being treated for hypertension in the absence of LVH do not appear to impact post-transplant outcomes. Level of Evidence: C. Recommendations regarding donors with coronary artery disease (CAD): 55,[118][119][120][121][122][123][124] (Table 3 Recommendations regarding donors with diabetes: 54,55,58,59,68,69,81,116,117,[128][129][130][131] Class IIa:…”

Section: Chronic Hypertension (Defined By Contemporary Guidelines) Or...mentioning

confidence: 99%

Donor heart selection: Evidence-based guidelines for providers

Copeland

Kneževič

Baran

et al. 2023

The Journal of Heart and Lung Transplantation

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Section: Chronic Hypertension (Defined By Contemporary Guidelines) Or...mentioning

confidence: 99%

Donor heart selection: Evidence-based guidelines for providers

Copeland

Kneževič

Baran

et al. 2023

The Journal of Heart and Lung Transplantation

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“…Performing coronary angiography represents another critical consideration in enhancing donor utility, particularly in the era of severe donor shortage. This approach is especially relevant for donors meeting expanded criteria, offering a valuable strategy to optimize the use of available donor hearts [ 63 , 64 ].…”

Section: Special Considerations For Cardiac Donorsmentioning

confidence: 99%

Management of potential cardiac donors

Hyun,

Lee,

Kim

2024

Clin Transplant Res

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Heart transplantation (HTx) outcomes have improved with careful donor selection and management; nonetheless, donor shortages remain a major challenge. Optimizing donor management is crucial for improving donor utility rates and post-HTx outcomes. Brain death leads to various pathophysiological changes that can affect multiple organs, including the heart. Understanding these alterations and corresponding management strategies is key to optimizing the donor organ condition. This review assesses several aspects of these pathophysiological changes, including hemodynamic and endocrinological considerations, and emphasizes special consideration for potential cardiac donors, including serial echocardiographic evaluations for reversible cardiac dysfunction and coronary assessments for donors with risk factors.

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“…These increased risks, however, may be outweighed when confronted with the alternative of a waitlist death (2,4). Donor transmitted CAD is of particular concern due to its significant association with early graft dysfunction when multi-vessel disease is present (5,6). ISHLT guidelines recommend that donor hearts with obstructive CAD in any major coronary artery be rejected (7).…”

Section: Current Donor Considerations For Angiographymentioning

confidence: 99%

“…ISHLT guidelines recommend that donor hearts with obstructive CAD in any major coronary artery be rejected (7). However, single vessel CAD does not differ in short or long-term prognosis when compared to donors without CAD (5).…”

Section: Current Donor Considerations For Angiographymentioning

confidence: 99%

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Coronary angiography utilization in the evaluation of a potential heart donor by age: a narrative review

Johnstad¹,

Fiedler²

2021

J Thorac Dis

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Heart transplant is the gold standard treatment for patients with heart failure. The limitation to providing heart transplantation to patients suffering from end stage heart disease is the stable organ supply within the United States despite increasing demand. Transplant centers across the United States have begun to expand traditional cardiac donor selection metrics previously utilized. As a result, the use of extended criteria donors, such as older donors, those with longer ischemic times, and donors considered high risk has increased. Current guidelines suggest that coronary angiography be performed when evaluating a donor above the age of 45. Angiographic guidelines for evaluation of the donor heart are based specifically on age, with little evidence based guidance surrounding the use of angiography in a younger donor with comorbidities or increased risk behavior which may lead to premature coronary artery disease. Recently, we have seen an increase in younger heart donors, many of whom have succumbed due to drug overdose with ensuing high risk behaviors. Given the increased risk nature of these donors, consideration of performing coronary angiography is determined by clinical "gestalt" of the transplant center evaluating the heart for use, which may lead to underutilization of donor organs without evidence to support the practice. Here, we review the guidelines, literature, and controversy surrounding the use of coronary angiography in evaluating donor hearts for transplantation.

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Performing diagnostic coronary angiography to evaluate high-risk cardiac donors: A French nationwide cohort study

Cited by 7 publications

References 29 publications

Donor heart selection: Evidence-based guidelines for providers

Donor heart selection: Evidence-based guidelines for providers

Management of potential cardiac donors

Coronary angiography utilization in the evaluation of a potential heart donor by age: a narrative review

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