Right ventricular dysfunction in neurologically deceased organ donors: An observational study in a tertiary-care organ donor referral centre

J Crit Care. 2019 Dec:54:37-41. doi: 10.1016/j.jcrc.2019.07.014. Epub 2019 Jul 15.

Abstract

Purpose: Right ventricular RV dysfunction among transplant recipients correlates with transplant outcome, but its frequency in donors is unknown. The purpose of this study was to describe the epidemiology of RV dysfunction in potential heart donors."

Methods: In a seven-year retrospective study of potential heart donors, we explored the incidence of RV dysfunction as observed on echocardiography and explored the association of four distinct factors with RV dysfunction: brain injury diagnosis, thoracic trauma, vasopressin infusion and left ventricular (LV) dysfunction.

Results: All 123 potential heart donors underwent echocardiography: 55 had RV dysfunction (44.7%). Fourty-one (33.3%) had LV dysfunction. Isolated RV dysfunction was present in 27 subjects (22%). LV dysfunction was the only factor significantly associated with RV dysfunction (OR = 4.6 (95% CI 1.9-11.4)). We observed no difference in heart acceptance between subjects with or without RV dysfunction.

Conclusion: We observed a high frequency of RV dysfunction in a sample of potential heart donors. However, the temporal evolution of RV dysfunction, the hemodynamic predictors of RV dysfunction, as well the link between donor RV dysfunction and recipient outcomes need to be assessed with further prospective studies.

Keywords: Heart donor; Organ donation; Right ventricular dysfunction.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Death
  • Echocardiography*
  • Female
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Nervous System Diseases / complications
  • Nervous System Diseases / mortality*
  • Prospective Studies
  • Referral and Consultation
  • Retrospective Studies
  • Tertiary Care Centers
  • Tissue Donors*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Right / complications*
  • Ventricular Dysfunction, Right / epidemiology