Potential Impact of DCD Donor Recoveries on Heart Transplantation: Retrospective Analysis of a Limited UNOS Dataset
1New York Cardio-Thoracic Transplant Consortium, Troy, NY
2Columbia/New York Presbyterian Hospital, New York
3Montefiore Medical Center, Bronx, NY
4Rochester University Medical Center, Rochester, NY
5Westchester Medical Center, Valhalla, NY
6Mount Sinai Medical Center, New York, NY.
Meeting: 2018 American Transplant Congress
Abstract number: D20
Keywords: Donors, Heart preservation, Heart/lung transplantation, non-heart-beating
Session Information
Session Name: Poster Session D: Donor Management: All Organs Excluding Kidney
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Purpose: To review the volume and quality of potential DCD (Donation after Cardiac Death) Heart Transplant (HT) donors in the US, evaluate trends over time and the reasons for increased incidence of non-heart DCD donation, which may adversely affect Donation after Brain Death (DBD) heart transplantation.
Methods: We identified all DCD donors from 1/2011 – 3/1/2017 using the UNOS Database. We defined an ideal heart donor as age 18-49, EF > 50%, without known coronary disease or infectious/malignancy risks. We then reviewed the DCD donor charts in UNOS Region 9 and identified whether a brain death definition was met or other reasons why DCD over DBD was pursued.
Results: Of 8302 DCD donors across the US, 5019 (60%) were 18-49 years. 870 had a screening echocardiogram, with 573 (66%) measuring an EF > 50%, leaving 82.4% of the DCD donor pool without a heart donor evaluation. Of the 573 donors, 44 (7.7%) were from Region 9. In review of these 44 donor charts, we identified 36 (81.8%) acceptable heart donors, with average age 34.6 ± 7.9, 26.7% with HTN and 6.7% with DM. For the cohort of potential donors from Region 9, a definitive brain death declaration was made in 8 donors. Additional reasons for DCD was family preference. Region 9 trends in DCD donation revealed 4 unutilized hearts in 2011, increasing to 13 unutilized hearts in 2016.
Conclusions: DCD donation is increasing, providing an option for donation under time constraints or when brain death declaration is uncertain. Given international success in DCD heart donation using organ care systems, approved use of these devices in the US might increase the heart donor pool. Increasing collection of heart donor data on all DCD donors may quantify the total potential heart donor pool.
CITATION INFORMATION: Lindower J., Farr M., Taylor S., Jorde U., Chen L., Gass A., Truby L., Delair S., Pinney S. Potential Impact of DCD Donor Recoveries on Heart Transplantation: Retrospective Analysis of a Limited UNOS Dataset Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Lindower J, Farr M, Taylor S, Jorde U, Chen L, Gass A, Truby L, Delair S, Pinney S. Potential Impact of DCD Donor Recoveries on Heart Transplantation: Retrospective Analysis of a Limited UNOS Dataset [abstract]. https://atcmeetingabstracts.com/abstract/potential-impact-of-dcd-donor-recoveries-on-heart-transplantation-retrospective-analysis-of-a-limited-unos-dataset/. Accessed November 23, 2024.« Back to 2018 American Transplant Congress