Trends and outcomes of cardiac transplantation from donors dying of drug intoxication.
Trends and outcomes of cardiac transplantation from donors dying of drug intoxication.
复制标题
死于药物中毒的捐献者心脏移植的趋势和结果。
DOI：
10.1016/j.ahj.2018.02.003
复制
发表时间：
2018
影响因子：
4.8
通讯作者：
Mentz,RobertJ
中科院分区：
文献类型：
--
作者：
Warraich,HaiderJ;Lu,Di;Cobb,Stacy;Cooper,LaurenB;DeVore,Adam;Patel,ChetanB;Rosenberg,PaulB;Schroder,JacobN;Daneshmand,ManiA;Milano,CarmeloA;Hernandez,AdrianF;Rogers,JosephG;Mentz,RobertJ
背景在美国，药物中毒死亡率增加，但这些供体的原位心脏移植（OHT）受体的结局并没有很好的表征。方法我们对2000年1月至2014年3月器官共享联合网络的星星数据库进行了回顾性分析，并使用调整后的考克斯模型通过供体死亡机制评估了死亡率和再次移植。2000年至2014年的660例OHT中，1233例（3.9%）来自药物中毒。与死于其他机制的捐献者相比，这些捐献者更可能是女性、白色、烟草使用量更大、BMI更高。2000年，药物中毒占OHT供体的1.1%，2014年3月占6.2%。10年死亡率无显著差异（校正的风险比[HR]，95%置信区间[CI]：0.99，0.87-1.13），10年再次移植（调整后HR 0.84，0.49-1.41）或1年和3年与药物中毒相比，其他死亡机制导致的再住院时间为1年。毒品中毒在美国来自这些供体的OHT结果与死于其他机制的OHT结果相似。这些数据对在阿片类药物流行的背景下选择捐助者具有重要意义。
BackgroundDeaths from drug intoxication have increased in the United States but outcomes of recipients of orthotopic heart transplantation (OHT) from these donors are not well characterized.MethodsWe performed a retrospective analysis of the United Network for Organ Sharing's STAR database between January 2000 and March 2014 and assessed mortality and retransplantation using adjusted Cox models by mechanism of donor death.ResultsOf the 31,660 OHTs from 2000 to 2014, 1233 (3.9%) were from drug intoxication. These donors were more likely to be female, white, with greater tobacco use and higher BMI compared to donors who died of other mechanisms. Drug intoxication accounted for 1.1% of OHT donors in 2000 and 6.2% in March 2014. No significant difference was observed in 10-year mortality (adjusted hazard ratio [HR], 95% confidence interval [CI]: 0.99, 0.87-1.13), 10-year retransplantation (adjusted HR 0.84, 0.49-1.41) or 1-year and 3-year rehospitalization with other mechanisms of death compared to drug intoxication.ConclusionThere has been a large increase in OHT donors who die of drug intoxication in the United States. OHT outcomes from these donors are similar to those dying from other mechanisms. These data have important implications for donor selection in context of the ongoing opioid epidemic.