title: Potential suitability for transplantation of hearts from human non-heart-beating donors: data review from the Gift of Life Donor Program.
abstract: BACKGROUND
  Organ availability limits use of heart transplantation for treatment for end-stage heart disease. Hearts are currently obtained from donors declared brain dead (heart-beating donors [HBDs]). Although use of hearts from non-heart-beating donors (NHBDs) could reduce the shortage, they are considered unusable because of possible peri-mortem ischemic injury.
  
  
  METHODS
  To project how use of NHBD hearts could increase heart donation, we retrospectively reviewed donor databases from the Gift of Life Donor Program (GLDP), our local organ procurement organization, from 2001 through 2003. We screened the NHBD population using conservative donor criteria, assuming an acceptable hypoxic/ischemic time (time from withdrawal of care to cross-clamp) of 30 minutes.
  
  
  RESULTS
  During the study period, there were 894 HBDs, 334 heart transplants and 119 NHBDs. NHBDs were similar to HBDs with respect to gender and ethnicity, but NHBDs were proportionately younger. Of 119 NHBDs, 55 did not meet the age criteria (< or =45 years) and 20 were eliminated because of incomplete data. Eighty-two NHBDs were cross-clamped within 30 minutes of care withdrawal. Twenty NHBDs met all cardiac donor criteria, and 14 of these 20 had hypoxic/ischemic times < or =30 minutes. Pro rata estimation for the 20 NHBDs with incomplete data suggested 7 potential additional donors.
  
  
  CONCLUSIONS
  Based on our assumptions, 12% to 18% of NHBDs in the study period (14 to 21 of 119 total) were potential heart donors, representing a 4% to 6% increase over of the number of heart transplants performed during the same time interval.
authors.affiliation: Division of Cardiac and Thoracic Surgery, Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
authors.forename: Arun K
authors.initials: AK
authors.lastname: Singhal
authors.forename: John D
authors.initials: JD
authors.lastname: Abrams
authors.forename: Jun
authors.initials: J
authors.lastname: Mohara
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hasz
authors.forename: Howard M
authors.initials: HM
authors.lastname: Nathan
authors.forename: Carol A
authors.initials: CA
authors.lastname: Fisher
authors.forename: Satoshi
authors.initials: S
authors.lastname: Furukawa
authors.forename: Bruce I
authors.initials: BI
authors.lastname: Goldman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016027:Heart Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014184:Transplantation, Homologous; D052096:Warm Ischemia