Extended criteria donor organ use for heart-lung transplantation in the modern era
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/213779 |
Resumo: | Background: Demand for donor hearts and lungs exceeds their supply. Extended Criteria Donor (ECD) organs are used to help meet this demand, but their impact on heart-lung transplantation outcomes is poorly characterized. Methods and results: : The United Network for Organ Sharing was queried for data on adult heart-lung transplantation recipients (n = 447) from 2005‒2021. Recipients were stratified based on whether they received ECD hearts and/or lungs. Morbidity was analyzed using Kruskal-Wallis, chi-square, and Fisher's exact tests. Mortality was analyzed using Kaplan-Meier estimation, log-rank tests and Cox regression. Sixty-five (14.5%) patients received two ECD organs, 134 (30.0%) received only an ECD lung, and 65 (14.5%) only an ECD heart. Recipients of two ECD organs were older, more likely to have diabetes, and more likely transplanted from 2015‒2021 (p < 0.05). Groups did not differ by pre-transplant diagnosis, intensive care unit disposition, life support use, or hemodynamics. Group five-year survival rates ranged from 54.5% to 63.2% (p = 0.428). Groups did not differ by 30-day mortality, strokes, graft rejection, or hospital length of stay. Conclusions: Using ECD hearts and/or lungs for heart-lung transplantation is not associated with increased mortality and is a safe strategy for increasing donor organ supply in this complex patient population. |
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Clinics |
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Extended criteria donor organ use for heart-lung transplantation in the modern eraOrgan donor managementHeart-lung transplantationHeart transplantationLung transplantationBackground: Demand for donor hearts and lungs exceeds their supply. Extended Criteria Donor (ECD) organs are used to help meet this demand, but their impact on heart-lung transplantation outcomes is poorly characterized. Methods and results: : The United Network for Organ Sharing was queried for data on adult heart-lung transplantation recipients (n = 447) from 2005‒2021. Recipients were stratified based on whether they received ECD hearts and/or lungs. Morbidity was analyzed using Kruskal-Wallis, chi-square, and Fisher's exact tests. Mortality was analyzed using Kaplan-Meier estimation, log-rank tests and Cox regression. Sixty-five (14.5%) patients received two ECD organs, 134 (30.0%) received only an ECD lung, and 65 (14.5%) only an ECD heart. Recipients of two ECD organs were older, more likely to have diabetes, and more likely transplanted from 2015‒2021 (p < 0.05). Groups did not differ by pre-transplant diagnosis, intensive care unit disposition, life support use, or hemodynamics. Group five-year survival rates ranged from 54.5% to 63.2% (p = 0.428). Groups did not differ by 30-day mortality, strokes, graft rejection, or hospital length of stay. Conclusions: Using ECD hearts and/or lungs for heart-lung transplantation is not associated with increased mortality and is a safe strategy for increasing donor organ supply in this complex patient population.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2023-04-28info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/21377910.1016/j.clinsp.2023.100205Clinics; Vol. 78 (2023); 100205Clinics; v. 78 (2023); 100205Clinics; Vol. 78 (2023); 1002051980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/213779/195941Copyright (c) 2023 Clinicsinfo:eu-repo/semantics/openAccessWeingarten, NoahIyengar, AmitHerbst, David AlanHelmers, MarkMeldrum, DanikaGuevara-Plunkett, SaraDominic, JessicaAtluri, Pavan2023-07-06T13:05:39Zoai:revistas.usp.br:article/213779Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-07-06T13:05:39Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Extended criteria donor organ use for heart-lung transplantation in the modern era |
title |
Extended criteria donor organ use for heart-lung transplantation in the modern era |
spellingShingle |
Extended criteria donor organ use for heart-lung transplantation in the modern era Weingarten, Noah Organ donor management Heart-lung transplantation Heart transplantation Lung transplantation |
title_short |
Extended criteria donor organ use for heart-lung transplantation in the modern era |
title_full |
Extended criteria donor organ use for heart-lung transplantation in the modern era |
title_fullStr |
Extended criteria donor organ use for heart-lung transplantation in the modern era |
title_full_unstemmed |
Extended criteria donor organ use for heart-lung transplantation in the modern era |
title_sort |
Extended criteria donor organ use for heart-lung transplantation in the modern era |
author |
Weingarten, Noah |
author_facet |
Weingarten, Noah Iyengar, Amit Herbst, David Alan Helmers, Mark Meldrum, Danika Guevara-Plunkett, Sara Dominic, Jessica Atluri, Pavan |
author_role |
author |
author2 |
Iyengar, Amit Herbst, David Alan Helmers, Mark Meldrum, Danika Guevara-Plunkett, Sara Dominic, Jessica Atluri, Pavan |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Weingarten, Noah Iyengar, Amit Herbst, David Alan Helmers, Mark Meldrum, Danika Guevara-Plunkett, Sara Dominic, Jessica Atluri, Pavan |
dc.subject.por.fl_str_mv |
Organ donor management Heart-lung transplantation Heart transplantation Lung transplantation |
topic |
Organ donor management Heart-lung transplantation Heart transplantation Lung transplantation |
description |
Background: Demand for donor hearts and lungs exceeds their supply. Extended Criteria Donor (ECD) organs are used to help meet this demand, but their impact on heart-lung transplantation outcomes is poorly characterized. Methods and results: : The United Network for Organ Sharing was queried for data on adult heart-lung transplantation recipients (n = 447) from 2005‒2021. Recipients were stratified based on whether they received ECD hearts and/or lungs. Morbidity was analyzed using Kruskal-Wallis, chi-square, and Fisher's exact tests. Mortality was analyzed using Kaplan-Meier estimation, log-rank tests and Cox regression. Sixty-five (14.5%) patients received two ECD organs, 134 (30.0%) received only an ECD lung, and 65 (14.5%) only an ECD heart. Recipients of two ECD organs were older, more likely to have diabetes, and more likely transplanted from 2015‒2021 (p < 0.05). Groups did not differ by pre-transplant diagnosis, intensive care unit disposition, life support use, or hemodynamics. Group five-year survival rates ranged from 54.5% to 63.2% (p = 0.428). Groups did not differ by 30-day mortality, strokes, graft rejection, or hospital length of stay. Conclusions: Using ECD hearts and/or lungs for heart-lung transplantation is not associated with increased mortality and is a safe strategy for increasing donor organ supply in this complex patient population. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-04-28 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/213779 10.1016/j.clinsp.2023.100205 |
url |
https://www.revistas.usp.br/clinics/article/view/213779 |
identifier_str_mv |
10.1016/j.clinsp.2023.100205 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/213779/195941 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 78 (2023); 100205 Clinics; v. 78 (2023); 100205 Clinics; Vol. 78 (2023); 100205 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222767366275072 |