Extended donor ischemic times and recipient outcome after orthotopic cardiac transplantation.

ABSTRACT

BACKGROUND: The effect of extended donor ischemic times on mortality following heart transplantation is a matter of considerable debate. PATIENTS AND METHODS: A retrospective study of the 261 consecutive heart transplantations performed at the centre (University of Alberta, Edmonton, Alberta) between July 1985 and June 1999 was conducted. Patients were divided into the following two groups based on donor ischemic time 4 h or less and longer than 4 h. Donor and recipient factors were analyzed for their effects on 30-day and 90-day survival. RESULTS: Thirty-day mortality was not significantly greater with prolonged donor ischemic times (13%) than with shorter ischemic times (7%, P=0.14). There was also no significant increase in 90-day mortality with longer ischemic times (16%) than with shorter ischemic times (10%, P=0.27). Actuarial survival (10 years) was similar between the groups (P=0.33). Predictors of 30-day and 90-day mortality were cardiopulmonary bypass time (P<0.001 and P<0.001, respectively) and lower donor weight (P=0.008 and P=0.02, respectively). CONCLUSIONS: Longer donor ischemic times were not significantly related to decreased 30-day, 90-day or 10-year actuarial survival.