title: Under-utilization of donor hearts in the initial era of the heart transplant program in Korea- review of 13 years’ experience from the Korea national registry.
abstract: BACKGROUND
  Heart transplantation (HTPL) is the effective treatment option to improve quality of life as well as survival of terminal heart failure patients. Shortage of donors, however, limits HTPL to all indicated cases. The temporal trend and clinical characteristics of HTPL donors in Korea were therefore investigated.
  
  
  RESULTS
  Among 2,001 brain-death donors registered in Korean Network for Organ Sharing from February 2000 to May 2012, a total of 28% of hearts (n=552) were utilized for HTPL. The mean age of Korean heart donors was 10 years younger than that of heart recipients (33.2 ± 12 years vs. 43.2 ± 17 years, respectively). The oldest was 56 years old, and donors aged over 50 accounted for only 6.2% (n=34) of total cases. Female donors were utilized less than male donors (23.6% vs. 29.6%, respectively). To determine characteristics of declined donor heart candidates, subgroup analysis of echocardiographic data was done, and 74.6% had normal ventricular function and structure, although only 42.3% were actually transplanted. The utilization rate of donor hearts with minor echocardiography abnormalities was only 15.2%. Clinical outcomes of marginal heart donors were not different from non-marginal donors.
  
  
  CONCLUSIONS
  Although shortage of donor organs is an emerging issue, most donor hearts have been under-utilized in the past in Korea. In particular, aged and female donor hearts with minor echocardiographic abnormalities had a low rate of utilization.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Myung-Jin
authors.initials: MJ
authors.lastname: Cha
authors.forename: Hae-Young
authors.initials: HY
authors.lastname: Lee
authors.forename: Hyun-Jai
authors.initials: HJ
authors.lastname: Cho
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Hwang
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Kim
authors.forename: Byung-Hee
authors.initials: BH
authors.lastname: Oh
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000379:methods / Q000458:organization & administration / Q000592:standards; D019737:Transplants / Q000000981:diagnostic imaging / Q000600:supply & distribution*; D014463:Ultrasonography