Impact of Donor Asystole in Intestine Transplant.
Surgery, Indiana University, Indianapolis, IN
Meeting: 2017 American Transplant Congress
Abstract number: A268
Keywords: Adverse effects, Donors, Intestinal transplantation, marginal
Session Information
Session Name: Poster Session A: Small Bowel: All Topics
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Intestine transplantation has a high risk of post-transplant complications. For this reason, many intestine transplant centers are conservative in their choice of deceased donors, using only standard criteria donors. One reason to exclude a deceased donor intestine graft is because of donor asystole time. This paper reports the routine use of intestine and multivisceral grafts from deceased donors with prolonged asystole.
Methods
The study reviewed the records of all intestine transplant patients from a single center from 2003 to 2015. All donor records were reviewed in detail. Donor asystole was recorded as donor “down time” which comprised the total cumulative number of minutes that the donor received chest compressions during resuscitation before stabilizing to proceed to organ procurement. Clinical graft outcomes included early graft loss and graft complications.
Results
There were 246 transplants included in this study. There were 39% of donors overall with some asystole time recorded, 23% among adult and 62% among pediatric recipients (p<0.01). Asystole time ranged from 1 minute to 60 minutes (2 patients). Median donor age was 18 years. The median donor age decreased with increasing asystole time: 1-14 minutes, 18 years; 15-30 minutes, 15 years; and 30-60 minutes, 3 years. Among pediatric recipients, 22% of donors had asystole time more than 30 minutes. At 1-year post transplant, there was no difference in graft survival when stratified by donor asystole. There was also no difference in recipient length of hospital stay post transplant.
Conclusions
Donor asystole time alone should not be used to exclude the intestine or multivisceral graft from transplantation. At our center, there is an increased willingness to tolerate donor asystole time with decreasing donor age. Donor asystole is not associated with worse graft survival or longer hospital stay.
CITATION INFORMATION: Schroering J, Kubal C, Mangus R. Impact of Donor Asystole in Intestine Transplant. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Schroering J, Kubal C, Mangus R. Impact of Donor Asystole in Intestine Transplant. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-donor-asystole-in-intestine-transplant/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress