L'Ecuyer Thomas, Sloan Katherine, Tang Liwen
Department of Pediatrics, Wayne State University, Children's Hospital of Michigan Cardiology, Detroit, MI 48201, USA.
Pediatr Transplant. 2011 Nov;15(7):742-5. doi: 10.1111/j.1399-3046.2011.01565.x. Epub 2011 Aug 23.
Mortality is the highest of any solid organ in pediatric patients awaiting heart transplantation. Strategies to increase the donor pool are needed if survival to transplant is to improve. There can be reluctance to accept pediatric hearts for transplantation if the donor has received cardiopulmonary resuscitation (CPR). This study asked if donor CPR impacts the survival of pediatric heart transplant recipients. Analysis of the UNOS database was performed for all cardiac transplants performed in patients aged 0-18 yr, with donors classified as to whether they received CPR (CPR+) or not (CPR-). We compared overall survival and survival at 30 days, one yr, and five yr between groups. Within the CPR+ group, the impact of duration of CPR on survival was compared. The need for inotropic support and ejection fraction was compared between donor groups as a measure of organ function. Overall survival and survival at 30 days, one yr, and five yr did not differ in the CPR+ compared to the CPR- group. Within the CPR+ group, duration of CPR was unrelated to post-transplant survival. The need for inotropic support at procurement was similar, and ejection fraction did not differ between the CPR+ and CPR- groups. Donor CPR does not have a negative impact on pediatric heart transplant survival.
在等待心脏移植的儿科患者中，心脏是所有实体器官里死亡率最高的。如果要提高移植存活率，就需要增加供体库的策略。如果供体接受过心肺复苏（CPR），可能会有人不愿意接受其心脏用于移植。本研究探讨供体心肺复苏是否会影响小儿心脏移植受者的存活。对在0至18岁患者中进行的所有心脏移植进行了器官共享联合网络（UNOS）数据库分析，将供体分为接受过心肺复苏（CPR+）或未接受过心肺复苏（CPR-）两类。我们比较了两组之间的总体存活率以及30天、1年和5年的存活率。在CPR+组内，比较了心肺复苏持续时间对存活的影响。比较了供体组之间对正性肌力支持的需求和射血分数，作为器官功能的一项指标。与CPR-组相比，CPR+组的总体存活率以及30天、1年和5年的存活率并无差异。在CPR+组内，心肺复苏持续时间与移植后存活无关。获取时对正性肌力支持的需求相似，CPR+组和CPR-组之间的射血分数也无差异。供体心肺复苏对小儿心脏移植存活没有负面影响。
