title: Heart transplantation outcomes from cardiac arrest-resuscitated donors.
abstract: BACKGROUND
  The aim of this study was to compare the outcomes of heart transplantation from cardiopulmonary-resuscitated donors (CPR(+)) to those who received hearts from donors who did not require cardiopulmonary resuscitation (CPR(-)).
  
  
  METHODS
  This investigation was a retrospective analysis of UNOS adult heart transplantation donor and recipient data from May 1994 through July 2012. Discrete variables were compared using the chi-square test. Continuous variables were compared using the t-test. Patient and graft survival rates were calculated using the actuarial method and compared using Wilcoxon's test.
  
  
  RESULTS
  Of the 29,242 adult heart transplantations performed in USA during the study period, 1,396 patients (4.7%) received hearts from CPR(+) donors. The patients in the CPR(+) group were younger (25.5 ± 15 years vs 28.5 ± 14 years; p < 0.0001) and more likely to be female (31% vs 27%; p = 0.001). Mean duration of CPR in these donors was 20 minutes. UNOS listing status at the time of transplantation was Status 1A for 54.3% of those in the CPR(+) group and 46.9% in the CPR(-) group (p < 0.0001). More recipients were hospitalized and were in the intensive care unit at transplantation in the CPR(+) group (56% vs 51%; p = 0.0008). Recipient survival at 30 days, 1 year and 5 years was 95.2%, 88.2% and 72.9% in CPR(+) group, and 94.7%, 87.7% and 74.4% in the CPR(-) group, respectively. Similarly, graft survival at 30 days, 1 year and 5 years was 94.7%, 87.6% and 71.9% in the CPR(+) donor hearts, and 94.4%, 87.3% and 73.2% in the CPR(-) donor hearts, respectively.
  
  
  CONCLUSIONS
  This large, multicenter adult heart transplant database from across the USA did not show inferior outcomes in recipients of heart transplantation from selected CPR(+) donors. Recipient and graft survival were similar over 5 years of follow-up.
authors.affiliation: Division of Cardiothoracic Surgery, Virginia Commonwealth University, Richmond, Virginia. Electronic address: mquader@mcvh-vcu.edu.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Quader
authors.forename: Luke G
authors.initials: LG
authors.lastname: Wolfe
authors.forename: Vigneshwar
authors.initials: V
authors.lastname: Kasirajan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016887:Cardiopulmonary Resuscitation; D002648:Child; D046148:Donor Selection; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D014019:Tissue Donors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: cardiopulmonary resuscitation; donor selection; heart transplantation; ischemic preconditioning; recipient survival; risk factor