HEART DONATION - THE NEW-ZEALAND EXPERIENCE, 1987-1996

Aims. To audit all donor hearts offered to our unit, assess the outcom e, identify factors which might enhance the acceptance rate and provid e data on which to base and modify acceptance criteria Methods. Demogr aphic, clinical and outcome data were collected retrospectively and an alysed for all patients in whom brain death had been established and p ermission for organ donation obtained from the family prior to referra l to the transplant donor coordinator. Results. Over a nine year perio d (1987-96) 267 hearts were offered for transplantation. The mean dono r age was 31.2 years (2-72), 163 being male and 104 female. The cause of death was secondary to trauma in 52%, neurological in 44% and due t o hypoxia in 4%. The mean donor weight was 68 kg and the distribution of ABO blood group similar to the New Zealand population. Seventy-six hearts (28%) were implanted. Of the 191 not implanted no suitable reci pient was available for 98 (51%) according to blood group and body wei ght criteria, 38 donors (20%) were medically unsuitable, 37 (19%) were declined because of donor age, 16 (8%) because of a markedly abnormal echocardiogram and 2 (1%) for logistical reasons. Conclusions. Enhanc ed efforts are needed to increase public awareness of the benefits of organ donation. However, a greater number of heart transplants may be achieved by increasing the recipient pool.