BACKGROUND: The effect of extended donor ischemic times on mortality follow
ing heart transplantation is a matter of considerable debate,
PATIENTS AND METHODS: A retrospective study of the 261 consecutive heart tr
ansplantations performed at the centre (University of Alberta Edmonton, Alb
erta) between July 1985 and June 1999 was conducted. Patients were divided
into the following two groups based on donor ischemic time: 4 h or Less and
longer than 4 h. Donor and recipient factors were analyzed for their effec
ts on 30-day and 90-day survival,
RESULTS: Thirty-day mortality was not significantly greater with prolonged
donor ischemic times (13%) than with shorter ischemic times (7%, P=0.14). T
here was also no significant increase in 90-day mortality with longer ische
mic times (16%) than with shorter ischemic times (10%, P=0.27). Actuarial s
urvival (10 years) was similar between the groups (P=0.33). Predictors of 3
0-day and 90-day mortality were cardiopulmonary bypass time (P <0.001) and
P<0.001, respectively) and lower donor weight (P=0.008 and P=0.02, respecti
vely).
CONCLUSIONS: Longer donor ischemic times were not significantly related to
decreased 30-day, 90-day or 10-year actuarial survival.