title: Prolonged cardiac allograft ischemic time--no impact on long-term survival but at what cost?
abstract: BACKGROUND
  The aim of this paper was to review the outcomes of cardiac transplantation with regards to short- and long-term survival, focusing particularly on patients who receive organs with long ischemic times and the resource utilization necessary to support such patients through their postoperative period.
  
  
  METHODS
  A retrospective review of 420 consecutive cardiac transplants in a single institution was undertaken.
  
  
  RESULTS
  The five- and 10-yr survival rates for the entire group were 0.76 (95% CI: 0.72-0.80) and 0.60 (0.54-0.66). There was no decrease in mid- or long-term survival in patients who received organs with ischemic times over 300 min. Longer donor organ ischemic time was not associated with increased 30 d mortality but was significantly associated with longer intensive care bed stay, increased incidence of primary graft failure, need for mechanical support, and complications such as acute renal failures.
  
  
  CONCLUSIONS
  Although using donor organs with longer ischemic times for cardiac transplantation does not impact on survival, there is a significantly increased utilization of resources to ensure these patients survive the postoperative period.
authors.affiliation: The Alfred, CJOB Cardiothoracic Surgery Unit, Melbourne, Victoria, Australia. s.marasco@alfred.org.au
authors.forename: Silvana F
authors.initials: SF
authors.lastname: Marasco
authors.forename: Donald S
authors.initials: DS
authors.lastname: Esmore
authors.forename: Meroula
authors.initials: M
authors.lastname: Richardson
authors.forename: Michael
authors.initials: M
authors.lastname: Bailey
authors.forename: Justin
authors.initials: J
authors.lastname: Negri
authors.forename: Michael
authors.initials: M
authors.lastname: Rowland
authors.forename: David
authors.initials: D
authors.lastname: Kaye
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bergin
mesh_terms: D000328:Adult; D002315:Cardiopulmonary Bypass; D005260:Female; D016027:Heart Transplantation / Q000191:economics / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014184:Transplantation, Homologous; D018497:Ventricular Dysfunction, Right / Q000453:epidemiology; D014739:Victoria
chemical_list: D007166:Immunosuppressive Agents