| The alternate recipient list for heart transplantation: does it work? | |
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MedLine Citation:
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PMID: 9257255 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: One quarter of patients awaiting heart transplantation die while on the waiting list. This is largely due to the shortage of donor organs. The alternate recipient list was created to establish a means by which patients who would otherwise be turned down for heart transplantation solely because of age over 65 or a need for a third heart transplantation can receive organs considered marginal that may otherwise be wasted. The hope is that these patients may achieve improved survival with these substandard hearts than they would achieve with medical therapy alone. METHODS: Twenty-two patients ages 47 to 71 years (mean 66.7 years) were listed on the alternate recipient list at the University of California at Los Angeles Medical Center from 1991 to 1996. Seventeen patients underwent heart transplantation from the alternate waiting list. The outcome of this group was compared with the outcome of a contemporaneous group of 266 patients ages 18 to 66 years (mean age 52.1 years) from the standard heart transplantation waiting list. RESULTS: The early mortality rate for the patients in the alternate group was 11.8% (2/ 17). Actuarial survival from time of orthotopic heart transplantation at 6 months and 1 year was the same 74.5% at a mean follow-up was 13.4 months. In comparison, the early mortality rate for the patients on the standard list was 5.6% (15/266), and actuarial survival at 6 months and 1 year was 86.8% and 83.1%, respectively (mean follow-up was 30 months). There was no significant difference in early mortality rate or actuarial survival between the two groups. CONCLUSION: The alternate recipient list for heart transplantation is a valid and ethical option for patients who would otherwise be denied heart transplantation. It provides these patients with similar early and medium-term outcomes in comparison to patients on the standard list, and organs that may otherwise be wasted are used. |
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Authors:
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H Laks; F G Scholl; D C Drinkwater; A Blitz; M Hamilton; J Moriguchi; G Fonarow; J Kobashigawa |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 16 ISSN: 1053-2498 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 1997 Jul |
Date Detail:
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Created Date: 1997-09-09 Completed Date: 1997-09-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 735-42 Citation Subset: IM |
Affiliation:
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Division of Cardiothoracic Surgery, University of California, Los Angeles, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Female Heart / physiology Heart Transplantation* / mortality, physiology Humans Male Middle Aged Survival Rate Tissue Donors* Treatment Outcome Waiting Lists* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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