Dopamine treatment of locally procured donor hearts: relevance on postoperative cardiac histology and function.
Administration of catecholamines can lead to myocyte damage. Dopamine treatment is often used in potential cardiac donors to attain hemodynamic stability. Donor hearts exposed to dopamine are rejected or selected for transplantation without clearly defined criteria. A prospective study was undertaken to analyze the clinical relevance of dopamine-induced myocardial lesions in 25 hearts (21 male, 4 female; 15-40 years, mean: 26 +/- 7) that were later used for transplantation. Donors were divided into those who had received dopamine and those who had not. Dopamine doses ranged from 2-12.5 micrograms/kg/min (mean: 6.3 +/- 3). Time of administration was 3-26 hours (mean: 16 +/- 8). Use of dopamine was unrelated to donor electrocardiographic findings, intra- or postoperative death, or difficulty coming off by-pass. Postoperatively, filling pressures were similar in both groups of patients at 2 and 10 days postoperatively. Left ventricular ejection fraction was similar in the two groups. Dopamine requirements were significantly higher in the dopamine-treated hearts (P = 0.05). Histologic findings at first biopsy revealed infiltration and cell damage in a similar proportion of patients in both groups.


CONCLUSIONS
donor hearts exposed to dopamine can be accepted for transplantation if doses ranging from 2-12.5 micrograms/kg/min have been administered up to 24 hours.
Ballester
M
M
Departamento de Cardiologia, Servicio de Anatomia Patológica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Obrador
D
D
Abadal
L
L
Cladellas
M
M
Bordes
R
R
Manito
N
N
Pons-Lladó
G
G
Padró
J M
JM
Arís
A
A
Caralps-Riera
J M
JM
D000293:Adolescent; D000328:Adult; D004298:Dopamine / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D005260:Female; D016027:Heart Transplantation; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects*; D009206:Myocardium / Q000473:pathology*; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D014019:Tissue Donors
D004298:Dopamine