The cardiac donor: a six-year experience.
From March 1, 1979, to March 1, 1985, the University of Arizona received 223 cardiac donor referrals. Sixty-two were accepted: 15 local, 23 regional (less than 370 km or 200 nautical miles), and 24 distant (370 to 1556 km or 200 to 840 nautical miles). Thirty-eight donor deaths were due to motor vehicle accidents, 10 to gunshot wounds, 6 to cerebral disease, and 8 to other closed-head lesions. The mean time from injury to brain death was 65 +/- 5 hours (+/- standard error of the mean [SEM]) and from brain death to organ donation, 12 +/- 3 hours. The mean ischemic time for the donor hearts ranged from 30 to 233 minutes (mean +/- SEM, 128 +/- 7 minutes). Fifty patients, otherwise acceptable, were refused as cardiac donors because an ABO-compatible recipient was not available. Two regionally procured hearts failed at operation, 1 because of unrecognized donor sepsis and 1 from a patient on large-dose inotropic support. Although there was no difference in myocardial function, median survival with follow-up through June 30, 1985, of patients receiving locally, regionally, and distantly procured organs was 59 months, 18 months, and 21 months, respectively. Cumulative proportion 1-year survival was 93%, 56%, and 61%, respectively. The 2-year survival was 85% for patients given locally procured hearts, 43% for those with regionally procured hearts, and 38% for those with a heart from a distant donor. Survival curves showed significantly longer survival for locally procured organs than regionally or distantly procured organs (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D001130:Arizona; D001926:Brain Death; D005260:Female; D005440:Fluid Therapy; D006085:Graft Survival; D016027:Heart Transplantation; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008722:Methods; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009599:Nitroprusside / Q000627:therapeutic use; D009926:Organ Preservation; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000401:mortality; D014187:Transportation of Patients
D009599:Nitroprusside