Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons.
Background: Local surgeon recovery of donor livers and kidneys is common and well-studied. This practice is rare and poorly studied in cardiac transplantation. We examined clinical outcomes of cardiac allografts recovered by local surgeons vs. recipient institution surgeons. Methods: A retrospective...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133425000126 |
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| author | Awab Ahmad, MD Timothy R. Harris, MD Aaron Williams, MD Alexandra DeBose-Scarlett, MD Rubayet Kamal, BS Enock Atta Adjei, MD Hasan K. Siddiqi, MD Chen Chia Wang Mark Petrovic Clifton D. Keck Shelley R. Scholl, RN Ashish S. Shah, MD Swaroop Bommareddi, MD Brian Lima, MD MBA John M. Trahanas, MD |
| author_facet | Awab Ahmad, MD Timothy R. Harris, MD Aaron Williams, MD Alexandra DeBose-Scarlett, MD Rubayet Kamal, BS Enock Atta Adjei, MD Hasan K. Siddiqi, MD Chen Chia Wang Mark Petrovic Clifton D. Keck Shelley R. Scholl, RN Ashish S. Shah, MD Swaroop Bommareddi, MD Brian Lima, MD MBA John M. Trahanas, MD |
| author_sort | Awab Ahmad, MD |
| collection | DOAJ |
| description | Background: Local surgeon recovery of donor livers and kidneys is common and well-studied. This practice is rare and poorly studied in cardiac transplantation. We examined clinical outcomes of cardiac allografts recovered by local surgeons vs. recipient institution surgeons. Methods: A retrospective review of all recoveries of adult cardiac allografts from brain dead donors for a single academic transplant center between 1/2020 and 12/2021 was performed. Donor and recipient baseline characteristics, distance traveled and ischemic time, and recipient outcomes were collected. Primary graft dysfunction (PGD) was determined based on 2014 ISHLT guidelines. Results: 218 recovery attempts were included, 25 conducted by local surgeons. Donor demographics between the two groups were similar, with a mean age of 31.5±10 years. There was a non-significant trend towards higher acceptance rates by local surgeons compared to recipient center surgeons (96% vs 82.9%, p=0.139). Ischemic times (208±28 vs 176±61 min p=0.003) and travel distances (788 vs 615 miles, p=0.011) were longer in the local recovery group. There was no difference in severe PGD (4.2% vs 7.5%, p=1.0), moderate/severe PGD (12.5% vs 14.4%, p=0.22) or 30-day survival (95.8% vs 95%, p=0.218) between the local surgeon and recipient center recovered allografts. Conclusion: Cardiac allografts recovered by a local surgeon team are high quality with similar rates of organ acceptance, PGD, and 30-day survival. This provides evidence that leveraging the expertise of the local surgical team is a safe and effective method for decreasing travel risks, financial expenditure, and opportunity cost associated with cardiac allograft recovery. |
| format | Article |
| id | doaj-art-273c21af48f946b9b4550597da883fef |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-273c21af48f946b9b4550597da883fef2025-02-09T05:02:04ZengElsevierJHLT Open2950-13342025-02-017100217Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons.Awab Ahmad, MD0Timothy R. Harris, MD1Aaron Williams, MD2Alexandra DeBose-Scarlett, MD3Rubayet Kamal, BS4Enock Atta Adjei, MD5Hasan K. Siddiqi, MD6Chen Chia Wang7Mark Petrovic8Clifton D. Keck9Shelley R. Scholl, RN10Ashish S. Shah, MD11Swaroop Bommareddi, MD12Brian Lima, MD MBA13John M. Trahanas, MD14Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNMeharry Medical College School of Medicine, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiology, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TNDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville TN; Reprint requests: John Trahanas, 1215 21st Avenue South, Suite 5025, Vanderbilt MCE, Nashville, TN 37232.Background: Local surgeon recovery of donor livers and kidneys is common and well-studied. This practice is rare and poorly studied in cardiac transplantation. We examined clinical outcomes of cardiac allografts recovered by local surgeons vs. recipient institution surgeons. Methods: A retrospective review of all recoveries of adult cardiac allografts from brain dead donors for a single academic transplant center between 1/2020 and 12/2021 was performed. Donor and recipient baseline characteristics, distance traveled and ischemic time, and recipient outcomes were collected. Primary graft dysfunction (PGD) was determined based on 2014 ISHLT guidelines. Results: 218 recovery attempts were included, 25 conducted by local surgeons. Donor demographics between the two groups were similar, with a mean age of 31.5±10 years. There was a non-significant trend towards higher acceptance rates by local surgeons compared to recipient center surgeons (96% vs 82.9%, p=0.139). Ischemic times (208±28 vs 176±61 min p=0.003) and travel distances (788 vs 615 miles, p=0.011) were longer in the local recovery group. There was no difference in severe PGD (4.2% vs 7.5%, p=1.0), moderate/severe PGD (12.5% vs 14.4%, p=0.22) or 30-day survival (95.8% vs 95%, p=0.218) between the local surgeon and recipient center recovered allografts. Conclusion: Cardiac allografts recovered by a local surgeon team are high quality with similar rates of organ acceptance, PGD, and 30-day survival. This provides evidence that leveraging the expertise of the local surgical team is a safe and effective method for decreasing travel risks, financial expenditure, and opportunity cost associated with cardiac allograft recovery.http://www.sciencedirect.com/science/article/pii/S2950133425000126local organ recoveryheart transplantprimary graft dysfunctionorganpreservation |
| spellingShingle | Awab Ahmad, MD Timothy R. Harris, MD Aaron Williams, MD Alexandra DeBose-Scarlett, MD Rubayet Kamal, BS Enock Atta Adjei, MD Hasan K. Siddiqi, MD Chen Chia Wang Mark Petrovic Clifton D. Keck Shelley R. Scholl, RN Ashish S. Shah, MD Swaroop Bommareddi, MD Brian Lima, MD MBA John M. Trahanas, MD Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons. JHLT Open local organ recovery heart transplant primary graft dysfunction organ preservation |
| title | Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons. |
| title_full | Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons. |
| title_fullStr | Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons. |
| title_full_unstemmed | Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons. |
| title_short | Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons. |
| title_sort | save a trip clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons |
| topic | local organ recovery heart transplant primary graft dysfunction organ preservation |
| url | http://www.sciencedirect.com/science/article/pii/S2950133425000126 |
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