Hormonal resuscitation yields more transplanted hearts, with improved early function

TitleHormonal resuscitation yields more transplanted hearts, with improved early function
Publication TypeJournal Article
Year of Publication2003
AuthorsRosendale JD, Kauffman HM, McBride MA, Chabalewski FL, Zaroff JG, Garrity ER, Delmonico FL, Rosengard BR
Pagination1336 - 41
Date Published46478
Accession Number12717226
Keywords*Brain Death, *Heart Transplantation, *Tissue Donors, Adult, Female, Glucocorticoids, Heart / *physiopathology, Hormones / *therapeutic use, Humans, Male, Methylprednisolone / therapeutic use, Middle Aged, Research Support, U.S. Gov't, P.H.S., Resuscitation / *methods, Retrospective Studies, Thyroxine / therapeutic use, Time Factors, Tissue Survival, Triiodothyronine / therapeutic use, Vasopressins / therapeutic use

BACKGROUND: Brain death results in cardiovascular instability and poor organ perfusion in many brain-dead donors. Hormonal resuscitation stabilizes certain brain-dead donors and is associated with significant increases in the numbers of organs transplanted per donor. The goal of this study was to examine the quality of hearts recovered from donors treated with hormonal resuscitation. METHODS: A retrospective analysis of 4,543 recipients of hearts recovered from brain-dead donors, reported to the United Network for Organ Sharing/Organ Procurement and Transplantation Network database between November 1, 1999, and December 31, 2001, was conducted. Hormonal resuscitation consisted of a methylprednisolone bolus and infusions of vasopressin and either triiodothyronine or l-thyroxine. Univariate and multivariate analyses were used to evaluate the quality of hearts from donors who received three-drug hormonal resuscitation (3HR) treatment versus donors who did not receive all three drugs (non-3HR). Death within 30 days and early graft dysfunction were used as endpoints. RESULTS: Hearts from 3HR donors demonstrated a 1-month survival rate of 96.2%, compared with a 92.1% survival rate for non-3HR donor hearts (P

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