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Previous Volume 359:709-714 August 14, 2008 Number 7 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Perspective by Bernat, J. L. Perspective by Veatch, R. M. Perspective by Truog, R. D. Editorial by Curfman, G. D. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

SUMMARY

In three infants awaiting orthotopic cardiac transplantation, transplantation was successfully performed with the use of organs from donors who had died from cardiocirculatory causes. The three recipients had blood group O and were in the highest-risk waiting-list category. The mean age of donors was 3.7 days, and the mean time to death after withdrawal from life support was 18.3 minutes. The 6-month survival rate was 100% for the 3 transplant recipients and 84% for 17 control infants who received transplants procured through standard organ donation. The mean number of rejection episodes among the three infants during the first 6 months after surgery was 0.3 per patient, as compared with 0.4 per patient among the controls. Echocardiographic measures of ventricular size and function at 6 months were similar among the three infants and the controls (left ventricular shortening fraction, 43.6% and 44.9%, respectively; P=0.73). No late deaths (within 3.5 years) have occurred in the three infants, and they have had functional and immunologic outcomes similar to those of controls. Mortality while awaiting a transplant is an order of magnitude higher in infants than in adults, and donors who died from cardiocirculatory causes offer an opportunity to decrease this waiting-list mortality.

Source Information

From the Department of Pediatrics, Joe DiMaggio Children's Hospital, Hollywood, FL (M.M.B., C.M.); Donor Alliance, Denver (S.M.D., R.F.); United Network for Organ Sharing, Richmond, VA (L.E.); and the Division of Pediatrics and Cardiothoracic Surgery, University of Colorado Health Sciences Center, Denver (B.P., D.C.).

Address reprint requests to Dr. Boucek at the Department of Pediatrics, Joe DiMaggio Children's Hospital, 1150 North Ave., Suite 575, Hollywood, FL, 33021, or at mboucek{at}mhs.net.

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