Arman Kilic, MD, Eric S. Weiss, MD, MPH, Jeremiah G

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Presentation transcript:

Should Orthotopic Heart Transplantation Using Marginal Donors Be Limited to Higher Volume Centers? Arman Kilic, MD, Eric S. Weiss, MD, MPH, Jeremiah G. Allen, MD, Timothy J. George, MD, David D. Yuh, MD, Ashish S. Shah, MD, John V. Conte, MD The Annals of Thoracic Surgery Volume 94, Issue 3, Pages 695-702 (September 2012) DOI: 10.1016/j.athoracsur.2012.03.069 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Distribution of donor risk score in the overall study population. Marginal donors were defined as having a score of 7 or greater (90th percentile). The Annals of Thoracic Surgery 2012 94, 695-702DOI: (10.1016/j.athoracsur.2012.03.069) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Effect of center volume in marginal donor orthotopic heart transplantation (OHT) stratified by nonmarginal versus marginal recipients, the latter being defined as having an Index for Mortality Prediction After Cardiac Transplantation (IMPACT) score greater than 10 (90th percentile of recipient risk). The Annals of Thoracic Surgery 2012 94, 695-702DOI: (10.1016/j.athoracsur.2012.03.069) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Kaplan-Meier 1-year survival curves: high volume, more than 25 orthotopic heart transplantation (OHT) per year (solid black line); intermediate volume, 14 to 25 OHT per year (broken line); and low volume, less than 14 OHT per year (solid gray line). The Annals of Thoracic Surgery 2012 94, 695-702DOI: (10.1016/j.athoracsur.2012.03.069) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Rates of postoperative adverse events: high volume, more than 25 orthotopic heart transplantation (OHT) per year (black bars); intermediate volume, 14 to 25 OHT per year (hatched bars); and low volume, less than 14 OHT per year (gray bars). The Annals of Thoracic Surgery 2012 94, 695-702DOI: (10.1016/j.athoracsur.2012.03.069) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Causes of posttransplant death: high volume, more than 25 orthotopic heart transplantation (OHT) per year (solid black line); intermediate volume, 14 to 25 OHT per year (broken line); and low volume, less than 14 OHT per year (solid gray line). (PGF = primary graft failure.) The Annals of Thoracic Surgery 2012 94, 695-702DOI: (10.1016/j.athoracsur.2012.03.069) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions