Impact of donor cardiopulmonary resuscitation on pediatric heart transplant outcome.

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.