Consensus conference report: maximizing use of organs recovered from the cadaver donor: cardiac recommendations, March 28-29, 2001, Crystal City, Va.
The shortage of available donor hearts continues to limit cardiac transplantation. For this reason, strict criteria have limited the number of patients placed on the US waiting list to approximately 6000 to 8000 per year. Because the number of available donor hearts has not increased beyond approximately 2500 per year, the transplant waiting list mortality rate remains substantial. Suboptimal and variable utilization of donor hearts has compounded the problem in the United States. In 1999, the average donor yield from 55 US regions was 39%, ranging from 19% to 62%. This report provides the detailed cardiac recommendations from the conference on "Maximizing Use of Organs Recovered From the Cadaver Donor" held March 28 to 29, 2001, in Crystal City, Va. The specific objective of the report is to provide recommendations to improve the evaluation and successful utilization of potential cardiac donors. The report describes the accuracy of current techniques such as echocardiography in the assessment of donor heart function before recovery and the impact of these data on donor yield. The rationale for and specific details of a donor-management pathway that uses pulmonary artery catheterization and hormonal resuscitation are provided. Administrative recommendations such as enhanced communication strategies among transplant centers and organ-procurement organizations, financial incentives for organ recovery, and expansion of donor database fields for research are also described.
Zaroff
Jonathan G
JG
UCSF Medical Center, San Francisco, Calif 94143-0124, USA. zaroff@medicine.ucsf.edu
Rosengard
Bruce R
BR
Armstrong
William F
WF
Babcock
Wayne D
WD
D'Alessandro
Anthony
A
Dec
G William
GW
Edwards
Niloo M
NM
Higgins
Robert S
RS
Jeevanandum
Valluvan
V
Kauffman
Myron
M
Kirklin
James K
JK
Large
Stephen R
SR
Marelli
Daniel
D
Peterson
Tammie S
TS
Ring
W Steves
WS
Robbins
Robert C
RC
Russell
Stuart D
SD
Taylor
David O
DO
Van Bakel
Adrian
A
Wallwork
John
J
Young
James B
JB
D002102:Cadaver; D006328:Cardiac Catheterization; D003142:Communication; D004452:Echocardiography; D006321:Heart / Q000502:physiology; D016027:Heart Transplantation / Q000000981:diagnostic imaging / Q000592:standards*; D006801:Humans; D014019:Tissue Donors / Q000145:classification / Q000600:supply & distribution; D009927:Tissue and Organ Procurement / Q000592:standards* / Q000639:trends; D014481:United States; D014850:Waiting Lists