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Poptsov VN, Zakharevich VM, Spirina EA, Khatutskii VM, Koloskova NN, Tunyaeva IY, Pchelnikov VV, Ustin SY, Masyutin SA, Voronkov VY, Dogonascheva AA, Aliev EZ. HEART TRANSPLANTATION FROM DONORS WITH LEFT VENTRICULAR EJECTION FRACTION <40%. RUSSIAN JOURNAL OF TRANSPLANTOLOGY AND ARTIFICIAL ORGANS 2018. [DOI: 10.15825/1995-1191-2018-2-29-36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Aim.Purpose of study was evaluated of early outcomes of HT performed from donors with LVEF <40%.Materials and methods.The study included 18 (14 men and 4 women, age 29 to 59 (42.9 ± 2.7) years) recipients who received cardiac allograft from donors with LVEF <40%. The urgency of HT was 1A-B (n = 16) and 2 status (n = 2) UNOS. 11 (55,6%) patients needed peripheral VA ECMO.Results.Heart donors (13 men and 5 women, 22 to 57 (39.1 ± 3) years) were the traumatic (n = 3) and non-traumatic (n = 15) brain damage. Maximal inotropic support was norepinephrine 433 ± 46.2 ng/kg /min (n = 14) and dopamine 5.6 ± 2.5 μg/kg/min (n = 4). Laboratory parameters of the heart donor blood: Hb 11.5 ± 0.7 g/l, total protein 72 ± 14 g/l, Na+ 139 ± 3 mmol/l, troponin I 0.3 ± 0.2 ng/ml, CK-MB 98 ± 18 U/l. ECG of the donor’s heart: LVEDV 134 ± 9 ml, LVEF 22–39 (35.3 ± 4.3)%, diffuse LV hypokinesis (n = 10), regional dyskinesis (n = 8). Ischemic time was 151 ± 27 min. 16 (88.9%) had acceptable cardiac allograft function. Primary graft failure treated by MCS (VAECMO (n = 2)) was in 2 (11.1%). ICU stay was 7.7 ± 1.2 days. All recipients were discharged at home.Conclusions.Own experience demonstrates the satisfactory results of HT from donors with LVEF <40%. In more cases LV systolic function of cardiac allograft quickly normalized in early period after HT.
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Affiliation(s)
- V. N. Poptsov
- V.I. Shumakov National Medical Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation
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