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DOI: 10.1055/s-2006-923889
© Georg Thieme Verlag KG Stuttgart · New York
The Controversy of Donor Serum Sodium Levels in Heart Transplantation - A Multicenter Experience
Publication History
Received November 16, 2005
Publication Date:
10 August 2006 (online)
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Abstract
Background: Elevated donor serum sodium is a phenomenon often encountered in the management of brain dead donors. The clinical relevance on recipient outcome is less examined. We investigated the impact of elevated donor serum sodium levels (DSL) on outcome after heart transplantation in 1800 heart transplantations. Methods: Data was conducted in a retrospective analysis from 1989 until 2005. The transplantations were performed at three German heart transplant centers. The joined database included DSL at the time of organ procurement, recipient and donor age, ischemia time, primary graft failure and survival data. Results: Mean DSL was 147.7 ± 10.3 l/l (range 111 - 208 l/l). Recipients were divided into 4 groups with percentiles of 141, 147, and 154 l/l resulting in DSL of A: 135.8 ± 4.4, B: 143.6 ± 1.7, C: 149.7 ± 1.9, and D: 161.3 ± 7.7 l/l for the four quartiles. Primary graft failure ocurred in 2.6 % of the patients with A: 2.8 %, B: 2.8 %, C: 3.7% and D: 1.4 % (p = n.s.). Mean 5- and 10-year-survival rates were 70.9 % (57.6 %) with A: 71.1 % (53.86 %), B: 69.3 % (53.9 %), C: 72.7 % (61.0 %), D: 71.2 % (62.4 %), respectively (p = n. s.). In a multivariate analysis a significant impact on postoperative results could be revealed for recipient age (p = 0.002), ischemia time (p = 0.002) and donor age (p = 0.009). DSL were no individual risk factor in the multivariate analysis. Conclusion: There was no impact of donor serum sodium levels neither on early postoperative results, nor on long-term outcome indicating that cardiac allografts from donors with elevated sodium levels might be transplanted successfully, achieving favourable results.
Key words
Heart and lung transplantation - allocation - marginal donors
References
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Ingo Kaczmarek
Department of Cardiac Surgery
Ludwig-Maximilians-University
Marchioninistraße 15
81377 München
Germany
Phone: + 498970950
Fax: + 49 89 70 95 88 73
Email: Ingo.Kaczmarek@med.uni-muenchen.de