AI Article Synopsis
- Transplantation success is hindered by a shortage of donor organs, but new organ maintenance systems could enhance the number of usable organs and improve transplant outcomes by reducing ischemic time (IT).
- A study using statistical methods found that each hour of increased IT raises the death risk for patients post-transplant, highlighting the critical relationship between IT and survival rates.
- If IT can be reduced to 1 hour, recipients may gain significant additional life-years, especially those facing longer IT durations, indicating that organ maintenance systems could greatly benefit heart transplant patients.
Article Abstract
Background: Transplantation is limited by the number of available donor organs. Donor organ maintenance systems are a recent technological advance. These systems may increase the number of donor organs that can be used and improve outcomes by decreasing donor organ ischemic time (IT). The purpose of this study was to determine the potential life-years gained if IT in the United Kingdom were decreased for cardiac transplantation.
Methods: Proportional hazards regression and extrapolation of survival rates beyond 20 years posttransplantation were used to estimate the effect of decreasing total IT on survival and the life-years gained over the lifetime of UK heart transplantation patients.
Results: Median survival posttransplantation was 10.4 years (95% CI 9.9 to 10.9). For each additional hour of donor organ IT, patients had a 25% increased risk of death after heart transplantation in the first year after transplant, with a 5% increase thereafter (P<0.001). On average, a recipient surviving 10 years posttransplantation could potentially gain 0.4 (95% CI 0.1 to 0.7) life-years if IT was reduced to 1 hr. The longer the IT, the greater the potential life-years to gain; for example, a recipient of an organ that would have had an IT of 6 hr without the use of an organ maintenance system might expect to gain 2.9 life-years (95% CI -0.6 to 6.4) if IT was reduced to 1 hr.
Conclusions: Use of cardiac donor organ maintenance systems has the potential to increase posttransplantation survival.
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| http://dx.doi.org/10.1097/TP.0b013e318190007d | DOI Listing |
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