2022, Vol. 26 ›› Issue (26): 4211-4215

Conventional versus marginal donor heart transplantation in patients with end-stage heart disease

Duan Zhengwei, Liu Yunfei   

Abstract: BACKGROUND: The lack of donor heart resources is a worldwide problem in heart transplantation. Broadening the inclusion criteria of donor heart and rationally applying marginal donor heart are effective ways to alleviate the lack of donor heart resources, and they are also the development direction of heart transplantation.
OBJECTIVE: To compare the effect of conventional donor and marginal donor heart transplantation in patients with end-stage heart disease.
METHODS: Eighty patients with end-stage heart disease who underwent heart transplantation from April 2018 to March 2021 were divided into a conventional donor group (56 patients) and a marginal donor group (24 patients). All patients were given orthotopic heart transplantation. Then operative indicators, serum biochemical and prognostic were compared between the two groups.
RESULTS AND CONCLUSION: Compared with the conventional donor group, the operation time [(465.35±62.45) min vs. (423.42±58.23) min, t=2.888, P < 0.05] was longer and intraoperative blood loss [(1 235.36±203.4) mL vs. (678.65±123.21) mL, t=15.075, P < 0.01)] was higher in the marginal donor group. During the follow-up of 12 months, there were no significant differences in serum creatine kinase MB isoenzyme, cardiac troponin I, total bilirubin, alanine aminotransferase and left ventricular ejection fraction between the two groups (t=0.693, 1.322, 1.514, 1.348, 1.285, P > 0.05). Compared with the conventional donor group (2%, 9%), incidence rates of infection and renal insufficiency were also significantly higher in the marginal donor group (17%, 29%; x2=6.349, 5.397, P < 0.05). On the premise of strict heart donor protection and perioperative management, marginal donor transplantation can achieve the surgical effect similar to conventional donor heart transplantation. However, complications such as postoperative infection and renal insufficiency should be prevented.
Key words: end-stage heart disease, heart transplantation, marginal donor, conventional donor, therapeutic outcome