Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of Guidelines
Background. Organ shortage has liberalised the acceptance criteria of grafts for heart transplantation, but which donor characteristics ultimately influence the decision to perform transplantation? For the first time this was evaluated using real-time donor data from the German organ procurement org...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2013/701854 |
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| author | Sylke Ruth Zeissig Carl-Ludwig Fischer-Froehlich Frank Polster Nils R. Fruehauf Guenter Kirste Irene Schmidtmann |
| author_facet | Sylke Ruth Zeissig Carl-Ludwig Fischer-Froehlich Frank Polster Nils R. Fruehauf Guenter Kirste Irene Schmidtmann |
| author_sort | Sylke Ruth Zeissig |
| collection | DOAJ |
| description | Background. Organ shortage has liberalised the acceptance criteria of grafts for heart transplantation, but which donor characteristics ultimately influence the decision to perform transplantation? For the first time this was evaluated using real-time donor data from the German organ procurement organization (DSO). Observed associations are discussed with regard to international recommendations and guidelines. Methods. 5291 German donors (2006–2010) were formally eligible for heart donation. In logistic regression models 160 donor parameters were evaluated to assess their influence on using grafts for transplantation (random split of cases: 2/3 study sample, 1/3 validation sample). Results. Successful procurement was determined by low donor age (OR 0.87 per year; 95% CI [0.85–0.89], P<0.0001), large donor height (OR 1.04 per cm; 95% CI [1.02–1.06], P<0.0001), exclusion of impaired left ventricular function or wall motion (OR 0.01; 95% CI [0.002–0.036], P<0.0001), arrhythmia (OR 0.05; 95% CI [0.009–0.260], P=0.0004), and of severe coronary artery disease (OR 0.003; 95% CI [<0.001–0.01], P<0.0001). Donor characteristics differed between cases where the procedure was aborted without and with allocation initiated via Eurotransplant. |
| format | Article |
| id | doaj-art-499b6f2ebc534b9f90acdb3122b5b9ca |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-499b6f2ebc534b9f90acdb3122b5b9ca2025-02-03T00:59:34ZengWileyJournal of Transplantation2090-00072090-00152013-01-01201310.1155/2013/701854701854Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of GuidelinesSylke Ruth Zeissig0Carl-Ludwig Fischer-Froehlich1Frank Polster2Nils R. Fruehauf3Guenter Kirste4Irene Schmidtmann5Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, GermanyDeutsche Stiftung Organtransplantation (DSO), Region Baden-Württemberg, Kriegerstraße 6, 70192 Stuttgart, GermanyDeutsche Gesellschaft für Gewebespende gGmbH, Feodor Lynen Straße 21, 30625 Hannover, GermanyLandesärztekammer Niedersachsen, Berliner Allee 20, 30175 Hannover, GermanyDeutsche Stiftung Organtransplantation (DSO), Region Baden-Württemberg, Kriegerstraße 6, 70192 Stuttgart, GermanyInstitut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, GermanyBackground. Organ shortage has liberalised the acceptance criteria of grafts for heart transplantation, but which donor characteristics ultimately influence the decision to perform transplantation? For the first time this was evaluated using real-time donor data from the German organ procurement organization (DSO). Observed associations are discussed with regard to international recommendations and guidelines. Methods. 5291 German donors (2006–2010) were formally eligible for heart donation. In logistic regression models 160 donor parameters were evaluated to assess their influence on using grafts for transplantation (random split of cases: 2/3 study sample, 1/3 validation sample). Results. Successful procurement was determined by low donor age (OR 0.87 per year; 95% CI [0.85–0.89], P<0.0001), large donor height (OR 1.04 per cm; 95% CI [1.02–1.06], P<0.0001), exclusion of impaired left ventricular function or wall motion (OR 0.01; 95% CI [0.002–0.036], P<0.0001), arrhythmia (OR 0.05; 95% CI [0.009–0.260], P=0.0004), and of severe coronary artery disease (OR 0.003; 95% CI [<0.001–0.01], P<0.0001). Donor characteristics differed between cases where the procedure was aborted without and with allocation initiated via Eurotransplant.http://dx.doi.org/10.1155/2013/701854 |
| spellingShingle | Sylke Ruth Zeissig Carl-Ludwig Fischer-Froehlich Frank Polster Nils R. Fruehauf Guenter Kirste Irene Schmidtmann Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of Guidelines Journal of Transplantation |
| title | Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of Guidelines |
| title_full | Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of Guidelines |
| title_fullStr | Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of Guidelines |
| title_full_unstemmed | Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of Guidelines |
| title_short | Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of Guidelines |
| title_sort | current practice of heart donor evaluation in germany multivariable risk factor analysis confirms practicability of guidelines |
| url | http://dx.doi.org/10.1155/2013/701854 |
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