title: Consensus conference report: maximizing use of organs recovered from the cadaver donor: cardiac recommendations, March 28-29, 2001, Crystal City, Va.
abstract: 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.
authors.affiliation: UCSF Medical Center, San Francisco, Calif 94143-0124, USA. zaroff@medicine.ucsf.edu
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Zaroff
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Rosengard
authors.forename: William F
authors.initials: WF
authors.lastname: Armstrong
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Babcock
authors.forename: Anthony
authors.initials: A
authors.lastname: D'Alessandro
authors.forename: G William
authors.initials: GW
authors.lastname: Dec
authors.forename: Niloo M
authors.initials: NM
authors.lastname: Edwards
authors.forename: Robert S
authors.initials: RS
authors.lastname: Higgins
authors.forename: Valluvan
authors.initials: V
authors.lastname: Jeevanandum
authors.forename: Myron
authors.initials: M
authors.lastname: Kauffman
authors.forename: James K
authors.initials: JK
authors.lastname: Kirklin
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Large
authors.forename: Daniel
authors.initials: D
authors.lastname: Marelli
authors.forename: Tammie S
authors.initials: TS
authors.lastname: Peterson
authors.forename: W Steves
authors.initials: WS
authors.lastname: Ring
authors.forename: Robert C
authors.initials: RC
authors.lastname: Robbins
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Russell
authors.forename: David O
authors.initials: DO
authors.lastname: Taylor
authors.forename: Adrian
authors.initials: A
authors.lastname: Van Bakel
authors.forename: John
authors.initials: J
authors.lastname: Wallwork
authors.forename: James B
authors.initials: JB
authors.lastname: Young
mesh_terms: 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