The current scarcity of satisfactory human heart transplant donors has led to the use of distant procurement of donor organs with prolonged total ischemic times (TIT). The effect of TIT is controversial and is important that the safe limits of TIT are determined. The effect of increasing TIT on cardiac index during the first 3 operative days (CI/1-3), total period of dopamine and dobutamine (D + D/Kg), maximum inotropic requirements and peak CPK-MB levels were assessed in 96 consecutive heart transplant recipients, at the University of Minnesota, to determine the relatiosnhip of these variables to TIT. TIT ranged from 61 to 288 min (mean 171.7 min). The population was divided into groups representing 30 minutes increments of IT. Although reduced levels of peak CPK-MB were evident in the lower TIT groups, cardiac function, support times and inotrope requirements were not different. We conclude that ischemic times of up to 5 hours are well tolerated and that other factors, such as donor heart function prior to harvest and possible ischemic damage during harvest and implantation, are more important determinants of early post-transplant function.
heart transplantation; heart transplantation; heart transplantation; heart transplantation; heart transplantation; heart transplantation