HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Nicholas G. Smedira Randall C. Starling Gonzalo V. Gonzalez-Stawinski Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Shea, K. J. Articles by Gonzalez-Stawinski, G. V. Search for Related Content PubMed PubMed Citation Articles by Shea, K. J. Articles by Gonzalez-Stawinski, G. V. Related Collections Transplantation - heart

Eur J Cardiothorac Surg 2007;31:452-456. doi:10.1016/j.ejcts.2006.12.015
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

The effect of a donor's history of active substance on outcomes following orthotopic heart transplantation

^a Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, United States
^b Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
^c Case Western Reserve School of Medicine, Cleveland, OH, United States

Received 15 September 2006; received in revised form 11 December 2006; accepted 12 December 2006.

^_* Corresponding author. Address: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, 9500 Euclid Ave. F24, Cleveland, OH 44195, United States. Tel.: +1 216 444 6708; fax: +1 216 445 3298. (Email: gonzalg{at}ccf.org).

Objective: To review the short-term and long-term outcomes of using heart donors with a history of substance abuse. Methods: Retrospective chart review was performed of heart recipients over an 8-year span. Charts provided demographics, mechanisms of donor death, and history of substance abuse. Additionally, charts were quarried for post-operative echocardiography and coronary angiogram results, serologic tests, and survival. Results: Between January 1997 and December 2005, 689 heart transplants were performed, 150 (21.8%) had a history positive for substance abuse. The mean donor age was 34.5 years (range 16–62 years); most common cause of death was traumatic head injury in 87 donors (58.0%). Most patients (76.0%) had a history of 1 ppd smoking for 5 years, 89 (59.3%) had a history of inhaled drug use, 75 (50.0%) alcohol abuse, and 12 (8.0%) intravenous drug use. At a mean follow-up of 8.3 days, 68 hearts (45.3%) had normal, 36 (24.0%) mild, 23 (15.3%) moderate, and 10 (6.7%) severe ventricular dysfunction by echocardiography. Furthermore, 110 hearts (73.3%) had normal coronaries, 20 (13.3%) had mild, and 2 (1.3%) had evidence of moderate coronary artery disease (CAD) on coronary angiogram at a mean follow-up of 9.8 months (range 0.1–43.7 months). All recipients who received organs from known hepatitis B, or C positive, donors converted to positive serologies. Overall post-transplant survival for the group was 89.8% at a mean follow up of 43.3 months (range 5.8–108.6 months). Conclusions: A history of donor substance abuse does not have a negative impact on overall survival, cardiac function, risk of transplant associated coronary artery disease (TCAD). In patients who receive organs from virus positive donors, the risk of viral conversion is high, but survival seems not to be influenced.

Key Words: Heart • Transplantation • Substance abuse • Illicit drugs • Outcomes