Objectives

To evaluate the influence of prolonged cardiopulmonary resuscitation (CPR) on outcomes in heart transplantation with higher risk donor hearts (HRDHs).

Methods

Patients transplanted in our hospital between May 2006 and December 2019 were divided into 2 groups, HRDH recipients and non HRDH recipients. HRDH was defined as meeting at least one of the following criteria: (1) donor left ventricular ejection fraction ≤ 50%, (2) donor-recipient predicted heart mass ratio < 0.8 or > 1.2, (3) donor age ≥ 55 years, (4) ischemic time > 4 h and (5) catecholamine index > 20. Recipients of HRDHs were divided into 3 groups according to the time of CPR (Group1: non-CPR, Group 2: less than 30 min-CPR, and Group 3: longer than 30 min CPR).

Results

A total of 125 recipients were enrolled in this study, composing of HRDH recipients (n = 97, 78%) and non HRDH recipients (n = 28, 22%). Overall survival and the rate of freedom from cardiac events at 10 years after heart transplantation were comparable between two groups. Of 97 HRDH recipients, 54 (56%) without CPR, 22 (23%) with CPR < 30 min, and 21 (22%) with CPR ≥ 30 min were identified. One-year survival rates were not significantly different among three groups. The 1-year rate of freedom from cardiac events was not also statistically different, excluding the patients with coronary artery disease found in early postoperative period, which was thought to be donor-transmitted disease. Multivariate logistics regression for cardiac events identified that the CPR duration was not a risk factor even in HRDH-recipients.

Conclusion

The CPR duration did not affect the outcomes after heart transplantation in HRDH recipients.

中文翻译：

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长时间心肺复苏对高风险供体心脏移植结果的影响

目标

评估长时间心肺复苏 (CPR) 对高风险供体心脏 (HRDH) 心脏移植结果的影响。

方法

2006年5月至2019年12月期间在我院移植的患者分为2组，HRDH接受者和非HRDH接受者。HRDH被定义为至少满足以下标准之一：（1）供体左心室射血分数≤50％，（2）供体-受体预测心脏质量比<0.8或>1.2，（3）供体年龄≥55岁， (4) 缺血时间 > 4 小时和 (5) 儿茶酚胺指数 > 20。HRDH 接受者根据 CPR 时间分为 3 组（组 1：非 CPR，组 2：少于 30 分钟 CPR，组3：CPR 时间超过 30 分钟）。

结果

本研究共有 125 名接受者参与，其中包括 HRDH 接受者（n  = 97，78%）和非 HRDH 接受者（n  = 28，22%）。心脏移植后 10 年，两组的总生存率和无心脏事件发生率相当。在 97 名 HRDH 接受者中，54 名 (56%) 没有进行 CPR，22 名 (23%) 进行 CPR < 30 分钟，21 名 (22%) 进行 CPR ≥ 30 分钟。三组之间的一年生存率没有显着差异。排除术后早期发现的冠状动脉疾病（被认为是供体传播疾病）的患者，1 年无心脏事件发生率也没有统计学差异。心脏事件的多变量逻辑回归表明，即使在 HRDH 接受者中，CPR 持续时间也不是危险因素。

结论

CPR 持续时间不影响 HRDH 受者心脏移植后的结果。