Long-term outcomes in heart transplantation using donors with a history of past and present cocaine use

Senthil Jayarajan, Sharven Taghavi, Eugene Komaroff, Akira Shiose, Daniel Schwartz, Eman Hamad, Rene Alvarez, Grayson Wheatley, Thomas Sloane Guy, Yoshiya Toyoda

研究成果: ジャーナルへの寄稿記事

11 引用 (Scopus)

抄録

OBJECTIVES: Organ donors with a history of cocaine use are thought to be less favourable for orthotopic heart transplantation (OHT). This study examined long-term survival in OHT using donors with a history of cocaine use. METHODS: The United Network for Organ Sharing (UNOS) database was examined for primary, adult heart transplants from 2000 to 2010. Cox proportional hazards analysis using covariates associated with mortality was used to examine survival. RESULTS: There were 19 636 total OHTs with 2274 (11.6%) using donors with a history of dependent cocaine use (DCU). Of these, 1008 (44.3%) donors were current cocaine users. Recipients of DCU were more likely to be male (79.0 vs 75.7%, P < 0.001), more likely diabetic (16.5 vs 14.8%, P = 0.003) and were less likely to be sex mismatched (23.0 vs 28.6%, P < 0.001). DCU donors were older (32.5 vs 31.4 years, P < 0.001), more likely male (79.7 vs 69.8%, P < 0.001) and had higher ischaemic times (3.27 vs 3.20 h, P = 0.001). On multivariate analysis, DCU was not associated with mortality [hazard ratio (HR): 0.95, 95% CI: 0.87-1.03, P = 0.22]. Variables associated with mortality included recipient body mass index, sex mismatch, race mismatch, black race, ischaemic time, recipient creatinine, donor age, donor smoking history and mechanical ventilation or extracorporeal membrane oxygen as a bridge to transplantation. On subset analysis, CCU was not associated with mortality (HR: 0.97, 95% CI: 0.89-1.05, P = 0.42). On Kaplan-Meier analysis, median survival was not different when comparing current (3890.0 days), past (3,889.0 days) and non-cocaine using donors (4165.0 days); P = 0.54. CONCLUSIONS: Use of carefully selected donors with a history of past and current cocaine use does not result in worse outcomes.

元の言語英語
記事番号ezu512
ページ(範囲)e146-e150
ジャーナルEuropean Journal of Cardio-thoracic Surgery
47
発行部数4
DOI
出版物ステータス出版済み - 4 1 2015
外部発表Yes

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Heart Transplantation
Cocaine
Tissue Donors
Mortality
Survival
Kaplan-Meier Estimate
Artificial Respiration
Creatinine
Body Mass Index
Multivariate Analysis
Transplantation
Smoking
History
Databases
Oxygen
Transplants
Membranes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

これを引用

Long-term outcomes in heart transplantation using donors with a history of past and present cocaine use. / Jayarajan, Senthil; Taghavi, Sharven; Komaroff, Eugene; Shiose, Akira; Schwartz, Daniel; Hamad, Eman; Alvarez, Rene; Wheatley, Grayson; Guy, Thomas Sloane; Toyoda, Yoshiya.

:: European Journal of Cardio-thoracic Surgery, 巻 47, 番号 4, ezu512, 01.04.2015, p. e146-e150.

研究成果: ジャーナルへの寄稿記事

Jayarajan, S, Taghavi, S, Komaroff, E, Shiose, A, Schwartz, D, Hamad, E, Alvarez, R, Wheatley, G, Guy, TS & Toyoda, Y 2015, 'Long-term outcomes in heart transplantation using donors with a history of past and present cocaine use', European Journal of Cardio-thoracic Surgery, 巻. 47, 番号 4, ezu512, pp. e146-e150. https://doi.org/10.1093/ejcts/ezu512
Jayarajan, Senthil ; Taghavi, Sharven ; Komaroff, Eugene ; Shiose, Akira ; Schwartz, Daniel ; Hamad, Eman ; Alvarez, Rene ; Wheatley, Grayson ; Guy, Thomas Sloane ; Toyoda, Yoshiya. / Long-term outcomes in heart transplantation using donors with a history of past and present cocaine use. :: European Journal of Cardio-thoracic Surgery. 2015 ; 巻 47, 番号 4. pp. e146-e150.
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title = "Long-term outcomes in heart transplantation using donors with a history of past and present cocaine use",
abstract = "OBJECTIVES: Organ donors with a history of cocaine use are thought to be less favourable for orthotopic heart transplantation (OHT). This study examined long-term survival in OHT using donors with a history of cocaine use. METHODS: The United Network for Organ Sharing (UNOS) database was examined for primary, adult heart transplants from 2000 to 2010. Cox proportional hazards analysis using covariates associated with mortality was used to examine survival. RESULTS: There were 19 636 total OHTs with 2274 (11.6{\%}) using donors with a history of dependent cocaine use (DCU). Of these, 1008 (44.3{\%}) donors were current cocaine users. Recipients of DCU were more likely to be male (79.0 vs 75.7{\%}, P < 0.001), more likely diabetic (16.5 vs 14.8{\%}, P = 0.003) and were less likely to be sex mismatched (23.0 vs 28.6{\%}, P < 0.001). DCU donors were older (32.5 vs 31.4 years, P < 0.001), more likely male (79.7 vs 69.8{\%}, P < 0.001) and had higher ischaemic times (3.27 vs 3.20 h, P = 0.001). On multivariate analysis, DCU was not associated with mortality [hazard ratio (HR): 0.95, 95{\%} CI: 0.87-1.03, P = 0.22]. Variables associated with mortality included recipient body mass index, sex mismatch, race mismatch, black race, ischaemic time, recipient creatinine, donor age, donor smoking history and mechanical ventilation or extracorporeal membrane oxygen as a bridge to transplantation. On subset analysis, CCU was not associated with mortality (HR: 0.97, 95{\%} CI: 0.89-1.05, P = 0.42). On Kaplan-Meier analysis, median survival was not different when comparing current (3890.0 days), past (3,889.0 days) and non-cocaine using donors (4165.0 days); P = 0.54. CONCLUSIONS: Use of carefully selected donors with a history of past and current cocaine use does not result in worse outcomes.",
author = "Senthil Jayarajan and Sharven Taghavi and Eugene Komaroff and Akira Shiose and Daniel Schwartz and Eman Hamad and Rene Alvarez and Grayson Wheatley and Guy, {Thomas Sloane} and Yoshiya Toyoda",
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T1 - Long-term outcomes in heart transplantation using donors with a history of past and present cocaine use

AU - Jayarajan, Senthil

AU - Taghavi, Sharven

AU - Komaroff, Eugene

AU - Shiose, Akira

AU - Schwartz, Daniel

AU - Hamad, Eman

AU - Alvarez, Rene

AU - Wheatley, Grayson

AU - Guy, Thomas Sloane

AU - Toyoda, Yoshiya

PY - 2015/4/1

Y1 - 2015/4/1

N2 - OBJECTIVES: Organ donors with a history of cocaine use are thought to be less favourable for orthotopic heart transplantation (OHT). This study examined long-term survival in OHT using donors with a history of cocaine use. METHODS: The United Network for Organ Sharing (UNOS) database was examined for primary, adult heart transplants from 2000 to 2010. Cox proportional hazards analysis using covariates associated with mortality was used to examine survival. RESULTS: There were 19 636 total OHTs with 2274 (11.6%) using donors with a history of dependent cocaine use (DCU). Of these, 1008 (44.3%) donors were current cocaine users. Recipients of DCU were more likely to be male (79.0 vs 75.7%, P < 0.001), more likely diabetic (16.5 vs 14.8%, P = 0.003) and were less likely to be sex mismatched (23.0 vs 28.6%, P < 0.001). DCU donors were older (32.5 vs 31.4 years, P < 0.001), more likely male (79.7 vs 69.8%, P < 0.001) and had higher ischaemic times (3.27 vs 3.20 h, P = 0.001). On multivariate analysis, DCU was not associated with mortality [hazard ratio (HR): 0.95, 95% CI: 0.87-1.03, P = 0.22]. Variables associated with mortality included recipient body mass index, sex mismatch, race mismatch, black race, ischaemic time, recipient creatinine, donor age, donor smoking history and mechanical ventilation or extracorporeal membrane oxygen as a bridge to transplantation. On subset analysis, CCU was not associated with mortality (HR: 0.97, 95% CI: 0.89-1.05, P = 0.42). On Kaplan-Meier analysis, median survival was not different when comparing current (3890.0 days), past (3,889.0 days) and non-cocaine using donors (4165.0 days); P = 0.54. CONCLUSIONS: Use of carefully selected donors with a history of past and current cocaine use does not result in worse outcomes.

AB - OBJECTIVES: Organ donors with a history of cocaine use are thought to be less favourable for orthotopic heart transplantation (OHT). This study examined long-term survival in OHT using donors with a history of cocaine use. METHODS: The United Network for Organ Sharing (UNOS) database was examined for primary, adult heart transplants from 2000 to 2010. Cox proportional hazards analysis using covariates associated with mortality was used to examine survival. RESULTS: There were 19 636 total OHTs with 2274 (11.6%) using donors with a history of dependent cocaine use (DCU). Of these, 1008 (44.3%) donors were current cocaine users. Recipients of DCU were more likely to be male (79.0 vs 75.7%, P < 0.001), more likely diabetic (16.5 vs 14.8%, P = 0.003) and were less likely to be sex mismatched (23.0 vs 28.6%, P < 0.001). DCU donors were older (32.5 vs 31.4 years, P < 0.001), more likely male (79.7 vs 69.8%, P < 0.001) and had higher ischaemic times (3.27 vs 3.20 h, P = 0.001). On multivariate analysis, DCU was not associated with mortality [hazard ratio (HR): 0.95, 95% CI: 0.87-1.03, P = 0.22]. Variables associated with mortality included recipient body mass index, sex mismatch, race mismatch, black race, ischaemic time, recipient creatinine, donor age, donor smoking history and mechanical ventilation or extracorporeal membrane oxygen as a bridge to transplantation. On subset analysis, CCU was not associated with mortality (HR: 0.97, 95% CI: 0.89-1.05, P = 0.42). On Kaplan-Meier analysis, median survival was not different when comparing current (3890.0 days), past (3,889.0 days) and non-cocaine using donors (4165.0 days); P = 0.54. CONCLUSIONS: Use of carefully selected donors with a history of past and current cocaine use does not result in worse outcomes.

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