Strategy of expanding marginal donor heart and elinical result / 中华器官移植杂志

ABSTRACT

Objective To study the strategy of expanding standard donor heart application and to analyze the clinical effect on applying expanding standard donor heart in heart transplantation.Methods 146 patients received heart transplantation in Fuwai Hospital Bering from June 2004 to February 2009.Expanding standard donor heart was defined as prolonged ischemic time over 6 h,advanced age up to 40,and blood type ABO mismathched.Blood type examination and PRA test were done before operation.The donor heart was preserved by sequential perfusion with cold St.Thomas and HTK solution.The patients were divided into groups according to different oversize body weight,ischemic time,and donor age Results There were 11 deaths after operation.Ischernic time of donor heart was 262.1±120.8 min,and that of 21 donors was over 360 min(the longest one was 605 min).There was no significant diffeFence in recipient properties before transplantation.and also there was no significant difference in mortality,heart function,heart rejection,and main morbidity after transplantation and during follow-up.Conclusion These data support continued aggressive utilization of expanding standard donor hearts in heart transplantation.Our experience demonstrates thatproperly expanding standard cardiac allografts application has no effects on the short- and long-term clinical outcome following heart transplantation.