title: Temporal Changes in Left Ventricular Systolic Function and Use of Echocardiography in Adult Heart Donors.
abstract: BACKGROUND
  One reason for refusal of donor hearts is the development of left ventricular systolic dysfunction, a condition reported to occur in up to 42 % of adults with brain death. Prior studies have suggested that appropriate donor management and evaluation of cardiac dysfunction with serial echocardiography (TTE) can improve organ procurement. The aims of our study are to examine the prevalence and describe longitudinal changes in cardiac dysfunction after brain death.
  
  
  METHODS
  A cross-sectional study was performed using the Life Center Northwest organ database to identify potential adult heart donors diagnosed with brain death between January 2011 and November 2013. 246 potential donors with at least one TTE following brain death were identified. 58 donors received serial TTEs. Echocardiograms were reviewed for cardiac dysfunction, defined as left ventricular ejection fraction (EF) <50 % and/or presence of regional wall motion abnormalities.
  
  
  RESULTS
  Cardiac dysfunction was present in 74 (30 %) patients. Age, body mass index, EF, and proportion of harvested organs differed significantly between the groups with and without cardiac dysfunction. Among patients receiving serial TTEs, 29 patients had cardiac dysfunction on initial TTE, with 15 (52 %) of these patients demonstrating resolved cardiac dysfunction over time leading to organ harvest.
  
  
  CONCLUSIONS
  To our knowledge, the present study is the largest study describing the use of serial TTE and its utilization in adult donors. The prevalence of cardiac dysfunction after adult brain death is high, but given enough time and support, many of these donors have improvement in cardiac function, ultimately leading to transplantation.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359724, Seattle, WA, 98104, USA, borbely@u.washington.edu.
authors.forename: Xenia I
authors.initials: XI
authors.lastname: Borbely
authors.forename: Vijay
authors.initials: V
authors.lastname: Krishnamoorthy
authors.forename: Shan
authors.initials: S
authors.lastname: Modi
authors.forename: Ali
authors.initials: A
authors.lastname: Rowhani-Rahbar
authors.forename: Edward
authors.initials: E
authors.lastname: Gibbons
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Souter
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
mesh_terms: D000328:Adult; D001926:Brain Death; D003430:Cross-Sectional Studies; D004452:Echocardiography; D006801:Humans; D008875:Middle Aged; D012042:Registries; D014019:Tissue Donors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*