Donor Heart Utilization following Cardiopulmonary Arrest and Resuscitation: Influence of Donor Characteristics and Wait Times in Transplant Regions.

IF 0.9 Q3 SURGERY Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-07-08 DOI:10.1155/2014/519401
Mohammed Quader, Luke Wolfe, Gundars Katlaps, Vigneshwar Kasirajan
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引用次数: 9

Abstract

Background. Procurement of hearts from cardiopulmonary arrest and resuscitated (CPR) donors for transplantation is suboptimal. We studied the influences of donor factors and regional wait times on CPR donor heart utilization. Methods. From UNOS database (1998 to 2012), we identified 44,744 heart donors, of which 4,964 (11%) received CPR. Based on procurement of heart for transplantation, CPR donors were divided into hearts procured (HP) and hearts not procured (HNP) groups. Logistic regression analysis was used to identify predictors of heart procurement. Results. Of the 4,964 CPR donors, 1,427 (28.8%) were in the HP group. Donor characteristics that favored heart procurement include younger age (25.5 ± 15 yrs versus 39 ± 18 yrs, P ≤ 0.0001), male gender (34% versus 23%, P ≤ 0.0001), shorter CPR duration (<15 min versus >30 min, P ≤ 0.0001), and head trauma (60% versus 15%). Among the 11 UNOS regions, the highest procurement was in Region 1 (37%) and the lowest in Region 3 (24%). Regional transplant volumes and median waiting times did not influence heart procurement rates. Conclusions. Only 28.8% of CPR donor hearts were procured for transplantation. Factors favoring heart procurement include younger age, male gender, short CPR duration, and traumatic head injury. Heart procurement varied by region but not by transplant volumes or wait times.

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心肺骤停和复苏后供体心脏的利用:移植地区供体特征和等待时间的影响。
背景。从心肺骤停和复苏(CPR)供者处获取心脏用于移植是次优的。我们研究了供者因素和区域等待时间对心肺复苏术供者心脏利用的影响。方法。从UNOS数据库(1998年至2012年)中,我们确定了44,744名心脏捐赠者,其中4,964名(11%)接受了心肺复苏术。根据获得移植用心脏的情况,将CPR供者分为获得心脏(HP)组和未获得心脏(HNP)组。采用Logistic回归分析确定心脏获取的预测因素。结果。在4964名心肺复苏术献血者中,1427名(28.8%)属于HP组。有利于心脏采买的供者特征包括年龄较小(25.5±15岁对39±18岁,P≤0.0001)、男性(34%对23%,P≤0.0001)、CPR持续时间较短(30分钟,P≤0.0001)和头部创伤(60%对15%)。在联合国系统的11个区域中,采购率最高的是区域1(37%),最低的是区域3(24%)。区域移植量和中位等待时间对心脏获取率没有影响。结论。只有28.8%的CPR供体心脏被用于移植。有利于心脏采购的因素包括年龄较小、男性、CPR持续时间短和颅脑外伤。心脏获取因地区而异,但不受移植量或等待时间的影响。
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自引率
4.00%
发文量
5
审稿时长
16 weeks
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