HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by de Begona, J. A. Articles by Bailey, L. L. Search for Related Content PubMed PubMed Citation Articles by de Begona, J. A. Articles by Bailey, L. L.

The Journal of Thoracic and Cardiovascular Surgery, Vol 106, 1196-1201, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Transplantation of hearts after arrest and resuscitation. Early and long-term results

JA de Begona, SR Gundry, AJ Razzouk, MM Boucek, M Kawauchi and LL Bailey
Department of Surgery, School of Medicine, Loma Linda University Medical Center, Calif. 92354.

Transplant surgeons are reluctant to use hearts that have undergone cardiopulmonary resuscitation for cardiac arrest because of the fear of poor early and late cardiac function. A policy of minimizing contraindications to use of donor hearts has led to the unique opportunity of assessing the effects of donor arrest and successful cardiopulmonary resuscitation on early and late cardiac function in pediatric heart transplantation. A number of 140 infants and children undergoing transplantation from birth to 17 years of age were studied retrospectively and divided into two groups on the basis of cardiopulmonary resuscitation status. Group 1 (72 patients) received donor hearts that were not subjected to cardiopulmonary resuscitation; group 2 (68 patients) received donor hearts that had cardiopulmonary resuscitation for a mean of 18.8 +/- 14.6 minutes, the longest period of time being 60 minutes. Mean ischemic times were almost identical in the two groups: 4.43 +/- 2.0 hours (cardiopulmonary resuscitation) versus 4.5 +/- 2.1 hours (no cardiopulmonary resuscitation). Early cardiac function was assessed on the basis of the number of days the recipient was supported by the ventilator, days receiving dopamine, days receiving isoproterenol, and the amount of inotropic agents required after the operation. The groups did not differ. Parameters of systolic function included fractional shortening, posterior wall thickening, and maximum velocity of change in left ventricular posterior wall dimension during systole. Diastolic function was measured on the basis of left ventricular end-diastolic volume, left ventricular mass, and maximum velocity of change in left ventricular posterior wall dimension during diastole. Both systolic and diastolic function were measured and analyzed from M-mode echocardiography at 1 week, 1 month, 6 months, 1 year, and 2 years after the operation. There were no statistically significant differences in graft function between the two groups in any of the echocardiographic parameters studied, even at 2 years. No group differed from ranges of normal. Our results suggest that hearts undergoing cardiopulmonary resuscitation for periods of up to 60 minutes can be used safely without evidence of deterioration of early or late cardiac function.

This article has been cited by other articles:

				N. A. G. Solomon, J. R. McGiven, P. M. Alison, P. N. Ruygrok, D. A. Haydock, H. A. Coverdale, and T. M. West Changing donor and recipient demographics in a heart transplantation program: influence on early outcome Ann. Thorac. Surg., June 1, 2004; 77(6): 2096 - 2102. [Abstract] [Full Text] [PDF]

				A. M. Scheule, G. J. Zimmerman, J. K. Johnston, A. J. Razzouk, S. R. Gundry, and L. L. Bailey Duration of Graft Cold Ischemia Does Not Affect Outcomes in Pediatric Heart Transplant Recipients Circulation, September 24, 2002; 106(12_suppl_1): I-163 - I-167. [Abstract] [Full Text] [PDF]

				R. J. Rodeheffer, D. C. Naftel, L. W. Stevenson, C. B. Porter, J. B. Young, L. W. Miller, J. L. Kenzora, G. J. Haas, J. K. Kirklin, and R. C. Bourge Secular Trends in Cardiac Transplant Recipient and Donor Management in the United States, 1990 to 1994: A Multi-Institutional Study Circulation, December 1, 1996; 94(11): 2883 - 2889. [Abstract] [Full Text]

				S. R. Gundry, N. Fukushima, C. C. Eke, A. C. Hill, C. Zuppan, and L. L. Bailey Successful survival of primates receiving transplantation with ""dead,""nonbeating donor hearts J. Thorac. Cardiovasc. Surg., June 1, 1995; 109(6): 1097 - 1102. [Abstract] [Full Text]