Donors with cardiac arrest: Improved organ recovery but no preconditioning benefit in liver allografts
Historically, organ recovery rates in donors with cardiac arrest (CA) have been low, presumably from hemodynamic instability. We hypothesized that donor resuscitation has improved hemodynamic stability and organ recovery in CA donors, and that CA triggers ischemic preconditioning (IP) in liver graft...
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| Veröffentlicht in: | Transplantation 2003-05, Vol.75 (10), p.1683-1687 |
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| creator | WILSON, Dorian J FISHER, Adrian DAS, Kasturi GOERLITZ, Fred HOLLAND, Bart K DE LA TORRE, Andrew N MERCHANT, Anand SEGUEL, Joseph SAMANTA, Arun K KONERU, Baburao |
| description | Historically, organ recovery rates in donors with cardiac arrest (CA) have been low, presumably from hemodynamic instability. We hypothesized that donor resuscitation has improved hemodynamic stability and organ recovery in CA donors, and that CA triggers ischemic preconditioning (IP) in liver grafts.
A total of 131 donor pairs with and without CA were matched in age, gender, and year of recovery. Hemodynamic stability was determined by vasopressor use. Abdominal and thoracic organs recovered and livers transplanted were compared between the groups. Liver graft function, injury, and IP benefit were examined by comparing liver chemistries after transplantation and postperfusion biopsies between recipients of grafts from both groups (n=40 each).
Hemodynamic stability was similar in both groups, but recovery of thoracic organs was significantly lower in CA versus non-CA donors (35 vs. 53%, P |
| doi_str_mv | 10.1097/01.TP.0000064542.63798.6B |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73348345</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>18949521</sourcerecordid><originalsourceid>FETCH-LOGICAL-c425t-d4acf6cffe85de2f449dd2ee40c0622bfc0529afbe048e2694518ff65d5eeb493</originalsourceid><addsrcrecordid>eNqFkUtvEzEQxy0EoqHlKyBzgNtu_faaGy2PVqpED-Fsee1xMNrYwd5Q9dt3QyPlyFxGM_rN84_Qe0p6Soy-JLRf3_fkYEpIwXrFtRl6dfUCrajkolNkIC_RihBBO8q5PkNvWvu94JJr_RqdUaa1HqRaofil5FIbfkjzL-xdDcl57GqFNn_Ct9tdLX8h4FI3LuMKfonqIx73M84F7w6JHNKcSk55g0fIENOMU8ZTWkDspqlsqotzu0CvopsavD36c_Tz29f19U139-P77fXnu84LJucuCOej8jHCIAOwKIQJgQEI4olibIyeSGZcHIGIAZgyQtIhRiWDBBiF4efo43PfZfE_--UIu03NwzS5DGXfrOZcDFzI_4J0MMJIRhfQPIO-ltYqRLuraevqo6XEHtSwhNr1vT2pYf-pYdXVUvvuOGQ_biGcKo_vX4APR8A176ZYXfapnTgxSCY140-DQ5Vs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>18949521</pqid></control><display><type>article</type><title>Donors with cardiac arrest: Improved organ recovery but no preconditioning benefit in liver allografts</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>WILSON, Dorian J ; FISHER, Adrian ; DAS, Kasturi ; GOERLITZ, Fred ; HOLLAND, Bart K ; DE LA TORRE, Andrew N ; MERCHANT, Anand ; SEGUEL, Joseph ; SAMANTA, Arun K ; KONERU, Baburao</creator><creatorcontrib>WILSON, Dorian J ; FISHER, Adrian ; DAS, Kasturi ; GOERLITZ, Fred ; HOLLAND, Bart K ; DE LA TORRE, Andrew N ; MERCHANT, Anand ; SEGUEL, Joseph ; SAMANTA, Arun K ; KONERU, Baburao</creatorcontrib><description>Historically, organ recovery rates in donors with cardiac arrest (CA) have been low, presumably from hemodynamic instability. We hypothesized that donor resuscitation has improved hemodynamic stability and organ recovery in CA donors, and that CA triggers ischemic preconditioning (IP) in liver grafts.
A total of 131 donor pairs with and without CA were matched in age, gender, and year of recovery. Hemodynamic stability was determined by vasopressor use. Abdominal and thoracic organs recovered and livers transplanted were compared between the groups. Liver graft function, injury, and IP benefit were examined by comparing liver chemistries after transplantation and postperfusion biopsies between recipients of grafts from both groups (n=40 each).
Hemodynamic stability was similar in both groups, but recovery of thoracic organs was significantly lower in CA versus non-CA donors (35 vs. 53%, P<0.01). On the other hand, recovery rates of three or more abdominal organs from CA donors approached those of non-CA donors (77 vs. 87%, not significant). Although significantly fewer livers were transplanted from CA donors (69 vs. 85%, P<0.01), posttransplantation graft function and injury parameters were similar between the two groups, and CA did not appear to trigger IP.
Compared with historical data, cardiovascular stability and abdominal organ recovery rates have improved considerably in CA donors. Liver grafts from CA donors function similarly to grafts from non-CA donors with no IP from CA. Our data support the increased use of livers and other organs from donors with CA.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/01.TP.0000064542.63798.6B</identifier><identifier>PMID: 12777856</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Abdomen - surgery ; Adolescent ; Adult ; Biological and medical sciences ; cardiac arrest ; Cohort Studies ; Female ; graft function ; Heart - physiopathology ; Heart Arrest ; Hemodynamics ; Humans ; Ischemic Preconditioning ; Liver - physiopathology ; Liver Transplantation - statistics & numerical data ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Middle Aged ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Tissue and Organ Harvesting ; Tissue Donors ; Transplantation, Homologous ; vasopressors</subject><ispartof>Transplantation, 2003-05, Vol.75 (10), p.1683-1687</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-d4acf6cffe85de2f449dd2ee40c0622bfc0529afbe048e2694518ff65d5eeb493</citedby><cites>FETCH-LOGICAL-c425t-d4acf6cffe85de2f449dd2ee40c0622bfc0529afbe048e2694518ff65d5eeb493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14852572$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12777856$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WILSON, Dorian J</creatorcontrib><creatorcontrib>FISHER, Adrian</creatorcontrib><creatorcontrib>DAS, Kasturi</creatorcontrib><creatorcontrib>GOERLITZ, Fred</creatorcontrib><creatorcontrib>HOLLAND, Bart K</creatorcontrib><creatorcontrib>DE LA TORRE, Andrew N</creatorcontrib><creatorcontrib>MERCHANT, Anand</creatorcontrib><creatorcontrib>SEGUEL, Joseph</creatorcontrib><creatorcontrib>SAMANTA, Arun K</creatorcontrib><creatorcontrib>KONERU, Baburao</creatorcontrib><title>Donors with cardiac arrest: Improved organ recovery but no preconditioning benefit in liver allografts</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Historically, organ recovery rates in donors with cardiac arrest (CA) have been low, presumably from hemodynamic instability. We hypothesized that donor resuscitation has improved hemodynamic stability and organ recovery in CA donors, and that CA triggers ischemic preconditioning (IP) in liver grafts.
A total of 131 donor pairs with and without CA were matched in age, gender, and year of recovery. Hemodynamic stability was determined by vasopressor use. Abdominal and thoracic organs recovered and livers transplanted were compared between the groups. Liver graft function, injury, and IP benefit were examined by comparing liver chemistries after transplantation and postperfusion biopsies between recipients of grafts from both groups (n=40 each).
Hemodynamic stability was similar in both groups, but recovery of thoracic organs was significantly lower in CA versus non-CA donors (35 vs. 53%, P<0.01). On the other hand, recovery rates of three or more abdominal organs from CA donors approached those of non-CA donors (77 vs. 87%, not significant). Although significantly fewer livers were transplanted from CA donors (69 vs. 85%, P<0.01), posttransplantation graft function and injury parameters were similar between the two groups, and CA did not appear to trigger IP.
Compared with historical data, cardiovascular stability and abdominal organ recovery rates have improved considerably in CA donors. Liver grafts from CA donors function similarly to grafts from non-CA donors with no IP from CA. Our data support the increased use of livers and other organs from donors with CA.</description><subject>Abdomen - surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>cardiac arrest</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>graft function</subject><subject>Heart - physiopathology</subject><subject>Heart Arrest</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Ischemic Preconditioning</subject><subject>Liver - physiopathology</subject><subject>Liver Transplantation - statistics & numerical data</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Tissue and Organ Harvesting</subject><subject>Tissue Donors</subject><subject>Transplantation, Homologous</subject><subject>vasopressors</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtvEzEQxy0EoqHlKyBzgNtu_faaGy2PVqpED-Fsee1xMNrYwd5Q9dt3QyPlyFxGM_rN84_Qe0p6Soy-JLRf3_fkYEpIwXrFtRl6dfUCrajkolNkIC_RihBBO8q5PkNvWvu94JJr_RqdUaa1HqRaofil5FIbfkjzL-xdDcl57GqFNn_Ct9tdLX8h4FI3LuMKfonqIx73M84F7w6JHNKcSk55g0fIENOMU8ZTWkDspqlsqotzu0CvopsavD36c_Tz29f19U139-P77fXnu84LJucuCOej8jHCIAOwKIQJgQEI4olibIyeSGZcHIGIAZgyQtIhRiWDBBiF4efo43PfZfE_--UIu03NwzS5DGXfrOZcDFzI_4J0MMJIRhfQPIO-ltYqRLuraevqo6XEHtSwhNr1vT2pYf-pYdXVUvvuOGQ_biGcKo_vX4APR8A176ZYXfapnTgxSCY140-DQ5Vs</recordid><startdate>20030527</startdate><enddate>20030527</enddate><creator>WILSON, Dorian J</creator><creator>FISHER, Adrian</creator><creator>DAS, Kasturi</creator><creator>GOERLITZ, Fred</creator><creator>HOLLAND, Bart K</creator><creator>DE LA TORRE, Andrew N</creator><creator>MERCHANT, Anand</creator><creator>SEGUEL, Joseph</creator><creator>SAMANTA, Arun K</creator><creator>KONERU, Baburao</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20030527</creationdate><title>Donors with cardiac arrest: Improved organ recovery but no preconditioning benefit in liver allografts</title><author>WILSON, Dorian J ; FISHER, Adrian ; DAS, Kasturi ; GOERLITZ, Fred ; HOLLAND, Bart K ; DE LA TORRE, Andrew N ; MERCHANT, Anand ; SEGUEL, Joseph ; SAMANTA, Arun K ; KONERU, Baburao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-d4acf6cffe85de2f449dd2ee40c0622bfc0529afbe048e2694518ff65d5eeb493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Abdomen - surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>cardiac arrest</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>graft function</topic><topic>Heart - physiopathology</topic><topic>Heart Arrest</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Ischemic Preconditioning</topic><topic>Liver - physiopathology</topic><topic>Liver Transplantation - statistics & numerical data</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Tissue and Organ Harvesting</topic><topic>Tissue Donors</topic><topic>Transplantation, Homologous</topic><topic>vasopressors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WILSON, Dorian J</creatorcontrib><creatorcontrib>FISHER, Adrian</creatorcontrib><creatorcontrib>DAS, Kasturi</creatorcontrib><creatorcontrib>GOERLITZ, Fred</creatorcontrib><creatorcontrib>HOLLAND, Bart K</creatorcontrib><creatorcontrib>DE LA TORRE, Andrew N</creatorcontrib><creatorcontrib>MERCHANT, Anand</creatorcontrib><creatorcontrib>SEGUEL, Joseph</creatorcontrib><creatorcontrib>SAMANTA, Arun K</creatorcontrib><creatorcontrib>KONERU, Baburao</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>WILSON, Dorian J</au><au>FISHER, Adrian</au><au>DAS, Kasturi</au><au>GOERLITZ, Fred</au><au>HOLLAND, Bart K</au><au>DE LA TORRE, Andrew N</au><au>MERCHANT, Anand</au><au>SEGUEL, Joseph</au><au>SAMANTA, Arun K</au><au>KONERU, Baburao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Donors with cardiac arrest: Improved organ recovery but no preconditioning benefit in liver allografts</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2003-05-27</date><risdate>2003</risdate><volume>75</volume><issue>10</issue><spage>1683</spage><epage>1687</epage><pages>1683-1687</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Historically, organ recovery rates in donors with cardiac arrest (CA) have been low, presumably from hemodynamic instability. We hypothesized that donor resuscitation has improved hemodynamic stability and organ recovery in CA donors, and that CA triggers ischemic preconditioning (IP) in liver grafts.
A total of 131 donor pairs with and without CA were matched in age, gender, and year of recovery. Hemodynamic stability was determined by vasopressor use. Abdominal and thoracic organs recovered and livers transplanted were compared between the groups. Liver graft function, injury, and IP benefit were examined by comparing liver chemistries after transplantation and postperfusion biopsies between recipients of grafts from both groups (n=40 each).
Hemodynamic stability was similar in both groups, but recovery of thoracic organs was significantly lower in CA versus non-CA donors (35 vs. 53%, P<0.01). On the other hand, recovery rates of three or more abdominal organs from CA donors approached those of non-CA donors (77 vs. 87%, not significant). Although significantly fewer livers were transplanted from CA donors (69 vs. 85%, P<0.01), posttransplantation graft function and injury parameters were similar between the two groups, and CA did not appear to trigger IP.
Compared with historical data, cardiovascular stability and abdominal organ recovery rates have improved considerably in CA donors. Liver grafts from CA donors function similarly to grafts from non-CA donors with no IP from CA. Our data support the increased use of livers and other organs from donors with CA.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>12777856</pmid><doi>10.1097/01.TP.0000064542.63798.6B</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen - surgery Adolescent Adult Biological and medical sciences cardiac arrest Cohort Studies Female graft function Heart - physiopathology Heart Arrest Hemodynamics Humans Ischemic Preconditioning Liver - physiopathology Liver Transplantation - statistics & numerical data Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Middle Aged Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Tissue and Organ Harvesting Tissue Donors Transplantation, Homologous vasopressors |
| title | Donors with cardiac arrest: Improved organ recovery but no preconditioning benefit in liver allografts |
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