2013 - ISODP 2013 Congress


This page contains exclusive content for the member of the following sections: TTS, ISODP. Log in to view.

Oral Presentation 4 on Graft and Patient Outcomes 1

42.6 - The Joint Impact of Donor and Recipient Parameters on the Outcome of Heart Transplantation in Germany after Donor Selection

Presenter: Guenter, Kirste, Freiburg, Germany
Authors: Irene Schmidtmann, Carl-Ludwig Fischer-Fröhlich, Marcus Kutschmann, Sylke R Zeissig, Nils R Frühauf, Frank Polster, Gunter Kirste

The Joint Impact of Donor and Recipient Parameters on the Outcome of Heart Transplantation in Germany after Donor Selection

Irene Schmidtmann3, Carl-Ludwig Fischer-Fröhlich1, Marcus Kutschmann2, Sylke R Zeissig3, Nils R Frühauf5, Frank Polster4, Gunter Kirste1

1Region Baden-Württemberg, Deutsche Stiftung Organtransplatnation, Stuttgart, Germany, 2BQS Institute for Quality and Patient Safety, Düsseldorf, Germany, 3Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany, 4Deutsche Gesellschaft für Gewebespende gGmbH, Hannover, Germany, 5Landesärztekammer Niedersachsen, Hannover, Germany

Background: Organ shortage in heart-transplantation (HTx) results in increased use of grafts from donors with substantial risk factors. It is discussed controversially which donor characteristics may be detrimental. Therefore, we evaluated the joint impact of donor and patient related risk factors in HTx on patient survival by multiple analysis in a nationwide multicenter study after donor selection was carried out.

Methods: The research database consists of data concerning hearts donated and transplanted in Germany between 2006 and 2008 as provided by Deutsche Stiftung Organtransplantation and the BQS-Institute. Multiple Cox regression (significance level 5%, hazard ratio [95%-CI]) was conducted (n=774, recipient age ≥18 years).

Results: Survival was significantly decreased by donor-age (1.021 [1.008-1.035] per year), non-traumatic cause of death (1.481 [1.079-2.034]), Troponin >0.1 ng/ml (2.075 [1.473-2.921]), ischemia time (1.197 [1.041-1.373] per hour), recipient-age (1.017 [1.002-1.031] per year) and in recipients with pulmonary vascular resistance ≥320 dyn*s*cm-5 (1.761 [1.115-2.781]), with ventilator dependency (3.174 [2.211-6.340]) or complex previous heart surgery (1.763 [1.270-2.449]).

Conclusion: After donor selection had been conducted, multiple Cox regression revealed donor-age, -non-traumatic cause of death, -Troponin  and ischemia time as well as recipient-age, -pulmonary hypertension, -ventilator dependency and -previous complex heart surgery  as limiting risk factors concerning patient survival.


Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.

Social

Contact

Staff Directory
+1-514-874-1717
info@tts.org

Address

The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada