High-dose catecholamine donor support and outcomes after heart transplantation.
J Heart Lung Transplant
; 37(5): 596-603, 2018 05.
Article
em En
| MEDLINE
| ID: mdl-29370971
ABSTRACT
BACKGROUND:
Higher dose norepinephrine donor support is a frequent reason for donor heart decline, but its associations with outcomes after heart transplantation are unclear.METHODS:
We retrospectively analyzed 965 patients transplanted between 1992 and 2015 in the Heart Transplant Program Vienna. Stratification was performed according to donor norepinephrine dose administered before organ procurement (Group 0 0 µg/kg/min; Group 1 0.01 to 0.1 µg/kg/min; Group 2 >0.1 µg/kg/min). Sub-stratification of Group 2 was performed for comparison of high-dose subgroups (Group HD 1 0.11 to 0.4 µg/kg/min; Group HD 2 >0.4 µg/kg/min). Associations between groups and outcome variables were investigated using a multivariable Cox proportional hazards model and logistic regression analyses.RESULTS:
Donor norepinephrine dose groups were not associated with overall mortality (Group 1 vs 0 hazard ratio [HR] 1.12, 95% confidence interval [CI] 0.87 to 1.43; Group 2 vs 0 HR 1.07, 95% CI 0.82 to 1.39; p = 0.669). No significant group differences were found for rates of 30-day mortality (p = 0.35), 1-year mortality (p = 0.897), primary graft dysfunction (p = 0.898), prolonged ventilation (p = 0.133) and renal replacement therapy (p = 0.324). Groups 1 and 2 showed higher rates of prolonged intensive care unit stay (18.9% vs 28.5% vs 27.5%, p = 0.005). High-dose subgroups did not differ significantly in 1-year mortality (Group HD 1 14.3%; Group HD 2 17.8%; p = 0.549).CONCLUSIONS:
Acceptance of selected donor hearts supported by higher doses of norepinephrine may be a safe option to increase the donor organ pool.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Catecolaminas
/
Transplante de Coração
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Heart Lung Transplant
Assunto da revista:
CARDIOLOGIA
/
TRANSPLANTE
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Áustria