Ventricular dysfunction associated with brain trauma is cause for exclusion of young heart donors.
OBJECTIVE
Ventricular dysfunction (VD) in the context of brain death (BD) is one medical cause that may be reversed to extend the range of donors for cardiac transplant programs. The aim of this study was to identify and quantify the causes for exclusion of potential heart donors and to define risk factors for VD among the BD population.


METHODS
This study of 100 heart-beating potential donors defined subjects as those younger than 50 years. We defined hemodynamic dysfunction (HD) as failure to achieve hemodynamic objectives despite the use of inotropic agents by protocol or upon diagnosing VD.


RESULTS
Among 246 BD subjects were 100 potential heart donors. Of these, 75 were transformed into real donors (RD) including 13 heart RD and 62 noncardiac RD. The conversion rate of BD subjects younger than 50 years to heart RD was 17%. When we analyzed the medical reasons for exclusion of the 62 donors who were not converted to heart RD, we observed that HD was the major cause (34%). When we analyzed the causes for exclusion related to cause of death, cranial trauma predominated (52%; P = .01; relative risk 3.5; 95% confidence interval 1.4-8.5).


CONCLUSIONS
Hemodynamic dysfunction represented the major cause for loss of heart donors; it was associated with younger patients with cranial trauma.
Godino
M
M
Instituto Nacional de Donación y Transplante, Hospital de Clínicas, Montevideo, Uruguay. mario333@mednet.org.uv
Lander
M
M
Cacciatore
A
A
Perez-Protto
S
S
Mizraji
R
R
D001926:Brain Death / Q000503:physiopathology*; D001930:Brain Injuries / Q000503:physiopathology*; D002318:Cardiovascular Diseases; D002423:Cause of Death; D046148:Donor Selection; D006321:Heart; D006323:Heart Arrest; D006801:Humans; D018579:Patient Selection; D020521:Stroke; D014019:Tissue Donors / Q000706:statistics & numerical data*; D018754:Ventricular Dysfunction / Q000503:physiopathology*; D014948:Wounds, Gunshot