Universität zu Köln

Benck, Urs, Hoeger, Simone, Brinkkoetter, Paul T., Gottmann, Uwe, Doenmez, Duygu, Boesebeck, Detlef, Lauchart, Werner, Gummert, Jan, Karck, Matthias, Lehmkuhl, Hans B., Bittner, Hartmuth B., Zuckermann, Andreas ORCID: 0000-0002-8054-8150, Wagner, Florian, Schulz, Uwe, Koch, Achim, Bigdeli, Amir K., Bara, Christoph, Hirt, Stephan, Berchtold-Herz, Michael, Brose, Stefan, Herold, Ulf, Boehm, Johannes, Welp, Henryk, Strecker, Thomas, Doesch, Andreas, Birck, Rainer, Kraemer, Bernhard K., Yard, Benito A. and Schnuelle, Peter (2011). Effects of Donor Pre-Treatment With Dopamine on Survival After Heart Transplantation A Cohort Study of Heart Transplant Recipients Nested in a Randomized Controlled Multicenter Trial. J. Am. Coll. Cardiol., 58 (17). S. 1768 - 1778. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1558-3597

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Abstract

Objectives We determined the outcome of cardiac allografts from multiorgan donors enrolled in a randomized trial of donor pre-treatment with dopamine. Background Treatment of the brain-dead donor with low-dose dopamine improves immediate graft function after kidney transplantation. Methods A cohort study of 93 heart transplants from 21 European centers was undertaken between March 2004 and August 2007. We assessed post-transplant left ventricular function (LVF), requirement of a left ventricular assist device (LVAD) or biventricular assist device (BVAD), need for hemofiltration, acute rejection, and survival of recipients of a dopamine-treated versus untreated graft. Results Donor dopamine was associated with improved survival 3 years after transplantation (87.0% vs. 67.8%, p = 0.03). Fewer recipients of a pre-treated graft required hemofiltration after transplant (21.7% vs. 40.4%, p = 0.05). Impaired LVF (15.2% vs. 21.3%, p = 0.59), requirement of a LVAD (4.4% vs. 10.6%, p = 0.44), and biopsy-proven acute rejection (19.6% vs. 14.9%, p = 0.59) were not statistically different between groups. Post-transplant impaired LVF (hazard ratio [HR]: 4.95; 95% confidence interval [CI]: 2.08 to 11.79; p < 0.001), requirement of LVAD (HR: 6.65; 95% CI: 2.40 to 18.45; p < 0.001), and hemofiltration (HR: 2.83; 95% CI: 1.20 to 6.69; p = 0.02) were predictive of death. The survival benefit remained (HR: 0.33; 95% CI: 0.12 to 0.89; p = 0.03) after adjustment for various risks affecting mortality, including pre-transplant LVAD/BVAD, inotropic support, and impaired kidney function. Conclusions Treatment of brain-dead donors with dopamine of 4 mu g/kg/min will not harm cardiac allografts but appears to improve the clinical course of the heart allograft recipient. (Prospective Randomized Trial to Evaluate the Efficacy of Donor Preconditioning With Dopamine on Initial Graft Function After Kidney Transplantation; NCT00115115) (J Am Coll Cardiol 2011;58:1768-77) (C) 2011 by the American College of Cardiology Foundation

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Benck, Urs UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoeger, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinkkoetter, Paul T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gottmann, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Doenmez, Duygu UNSPECIFIED UNSPECIFIED UNSPECIFIED Boesebeck, Detlef UNSPECIFIED UNSPECIFIED UNSPECIFIED Lauchart, Werner UNSPECIFIED UNSPECIFIED UNSPECIFIED Gummert, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Karck, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmkuhl, Hans B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bittner, Hartmuth B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zuckermann, Andreas UNSPECIFIED orcid.org/0000-0002-8054-8150 UNSPECIFIED Wagner, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulz, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Bigdeli, Amir K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bara, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Hirt, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Berchtold-Herz, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Brose, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Herold, Ulf UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehm, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Welp, Henryk UNSPECIFIED UNSPECIFIED UNSPECIFIED Strecker, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Doesch, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Birck, Rainer UNSPECIFIED UNSPECIFIED UNSPECIFIED Kraemer, Bernhard K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Yard, Benito A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnuelle, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-487196
DOI:	10.1016/j.jacc.2011.05.060
Journal or Publication Title:	J. Am. Coll. Cardiol.
Volume:	58
Number:	17
Page Range:	S. 1768 - 1778
Date:	2011
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1558-3597
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COLD-PRESERVATION; RENAL DYSFUNCTION; DOSE DOPAMINE; INJURY; HYPOTHERMIA; PREDICTORS; THERAPY; CALCIUM; CELLS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48719