Heart transplantation outcomes from cardiac arrest-resuscitated donors

BACKGROUND: The aim of this study was to compare the outcomes of heart transplantation from cardiopulmonary-resuscitated donors (CPR+) to those who received hearts from donors who did not require cardiopulmonary resuscitation (CPR-). METHODS: This investigation was a retrospective analysis of UNOS adult heart transplantation donor and recipient data from May 1994 through July 2012. Discrete variables were compared using the chi-square test. Continuous variables were compared using the t-test. Patient and graft survival rates were calculated using the actuarial method and compared using Wilcoxon's test. RESULTS: Of the 29,242 adult heart transplantations performed in USA during the study period, 1,396 patients (4.7%) received hearts from CPR+ donors. The patients in the CPR+ group were younger (25.5 +/- 15 years vs 28.5 +/- 14 years; p < 0.0001) and more likely to be female (31% vs 27%; p = 0.001). Mean duration of CPR in these donors was 20 minutes. UNOS listing status at the time of transplantation was Status 1A for 54.3% of those in the CPR+ group and 46.9% in the CPR- group (p < 0.0001). More recipients were hospitalized and were in the intensive care unit at transplantation in the CPR+ group (56% vs 51%; p = 0.0008). Recipient survival at 30 days, 1 year and 5 years was 95.2%, 88.2% and 72.9% in CPR+ group, and 94.7%, 87.7% and 74.4% in the CPR- group, respectively. Similarly, graft survival at 30 days, 1 year and 5 years was 94.7%, 87.6% and 71.9% in the CPR+ donor hearts, and 94.4%, 87.3% and 73.2% in the CPR- donor hearts, respectively. CONCLUSIONS: This large, multicenter adult heart transplant database from across the USA did not show inferior outcomes in recipients of heart transplantation from selected CPR+ donors. Recipient and graft survival were similar over 5 years of follow-up. Published by Elsevier Inc.