title: Low-Dose Donor Dopamine Is Associated With a Decreased Risk of Right Heart Failure in Pediatric Heart Transplant Recipients.
abstract: BACKGROUND
  Previous studies in adults have suggested that donor dopamine treatment may improve recipient outcomes in organ transplantation; in this analysis, we aimed to determine if donor dopamine reduces the incidence of postoperative right heart failure (RHF) in pediatric heart transplant recipients.
  
  
  METHODS
  Data for recipients aged 18 years or younger transplanted at our institution between January 1, 2000, and June 15, 2011, and their respective donors were obtained. The presence of postoperative RHF was assessed for in all subjects. Donor dopamine dose was stratified into 3 groups: none, low-dose (≤5 μg/kg per minute), and high-dose (>5 μg/kg per minute). Logistic regression was used to assess the relationship between donor dopamine dose and recipient RHF.
  
  
  RESULTS
  Of 192 recipients, 34 (18%) experienced postoperative RHF. There was no difference in baseline demographics between recipients with and without RHF. When controlling for pulmonary vascular resistance index, graft ischemic time, and cardiopulmonary bypass time, donor low-dose dopamine was independently associated with a decreased risk of RHF (odds ratio, 0.16; 95% confidence interval, 0.04-0.70; P = 0.02); however high-dose dopamine was neither associated with, nor protective of, RHF (odds ratio, 0.31; 95% confidence interval, 0.06-1.6; P = 0.16).
  
  
  CONCLUSIONS
  Despite advances in perioperative care of the recipient, RHF persists as a complication of pediatric heart transplantation. In this study, donor pretreatment with low-dose dopamine is associated with a decreased risk of postoperative RHF in pediatric heart recipients. Further studies into this association may be useful in determining the utility of empiric donor pretreatment with low-dose dopamine.
authors.affiliation: 1 Division of Pediatric Cardiology, Department of Pediatrics, Columbia University, New York, NY.2 Department of Medicine, Columbia University, New York, NY.3 Division of Pediatric and Congenital Cardiac Surgery, Department of Surgery Columbia University, New York, NY.
authors.forename: Marc E
authors.initials: ME
authors.lastname: Richmond
authors.forename: Rachel
authors.initials: R
authors.lastname: Easterwood
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Singh
authors.forename: Lisa
authors.initials: L
authors.lastname: Gilmore
authors.forename: Kimberly
authors.initials: K
authors.lastname: Beddows
authors.forename: Warren A
authors.initials: WA
authors.lastname: Zuckerman
authors.forename: Eric D
authors.initials: ED
authors.lastname: McFeely
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Chen
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Addonizio
mesh_terms: D002648:Child; D002675:Child, Preschool; D004298:Dopamine / Q000008:administration & dosage*; D005260:Female; D006085:Graft Survival; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology*; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D015994:Incidence; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D016017:Odds Ratio; D011184:Postoperative Period; D012044:Regression Analysis; D012189:Retrospective Studies; D012306:Risk; D014019:Tissue Donors; D016896:Treatment Outcome; D014655:Vascular Resistance
chemical_list: D004298:Dopamine