Thorac Cardiovasc Surg
DOI: 10.1055/s-0040-1710053
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Use of Organs for Heart Transplantation after Rescue Allocation: Comparison of Outcome with Regular Allocated High Urgent Recipients

Moritz Immohr
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Arash Mehdiani
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Charlotte Boettger
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Hannan Dalyanoglu
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Sophia Erbel
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Daniel Scheiber
2  Department of Cardiology, University Hospital, Duesseldorf, Germany
,
Ralf Westenfeld
2  Department of Cardiology, University Hospital, Duesseldorf, Germany
,
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Artur Lichtenberg
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
› Author Affiliations
Funding This study was funded by institutional grants of the Dept. of Cardiac Surgery, Medical Faculty, Heinrich Heine University Düsseldorf, Germany.
Further Information

Publication History

30 September 2019

30 March 2020

Publication Date:
22 May 2020 (online)

Abstract

Background The number of patients waiting for heart transplantation (HTx) is exceeding the number of actual transplants. Subsequently, waiting times are increasing. One possible solution may be an increased acceptance of organs after rescue allocation. These organs had been rejected by at least three consecutive transplant centers due to medical reasons.

Methods Between October 2010 and July 2019, a total of 139 patients underwent HTx in our department. Seventy (50.4%) of the 139 patients were transplanted with high urgency (HU) status and regular allocation (HU group); the remaining received organs without HU listing after rescue allocation (elective group, n = 69).

Results Donor parameters were comparable between the groups. Thirty-day mortality was comparable between HU patients (11.4%) and rescue allocation (12.1%). Primary graft dysfunction with extracorporeal life support occurred in 26.9% of the elective group with rescue allocated organs, which was not inferior to the regular allocated organs (HU group: 35.7%). No significant differences were observed regarding the incidence of common perioperative complications as well as morbidity and mortality during 1-year follow-up.

Conclusions Our data support the use of hearts after rescue allocation for elective transplantation of patients without HU status. We could show that patients with rescue allocated organs showed no significant disadvantages in the early perioperative morbidity and mortality as well at 1-year follow-up.