302: Female gender is associated with cardiac dysfunction in brain dead organ donors

Abstract

Purpose: In the setting of acute subarachnoid hemorrhage, female gender is associated with left ventricular (LV) systolic dysfunction and regional wall motion abnormalities (RWMA). This form of neurocardiogenic injury, which is often reversible, is likely due to excessive myocardial catecholamine release. We studied the association between female gender and LV dysfunction in a diverse population brain dead patients evaluated for organ donation. Methods and Materials: All potential cardiac organ donors managed by the California Transplant Donor Network between 2002-03, aged 14-60 years and without coronary artery disease, were included in this analysis. Univariate predictors of LV dysfunction were identified and multiple regression analysis was used to assess the relative independent contribution of each predictor. Results: 197 potential donors (122 male, 75 female, mean age 38 14 years) were studied. The cause of brain death was trauma in 64 potential organ donors, and non-traumatic (cerebrovascular death, anoxia, or other) in 133 potential donors. 12% had LV systolic dysfunction (LV ejection fraction 50%) and 15% had RWMA by echocardiography. Univariate analyses revealed that female gender, smaller donor size (weight, height, and body-mass index), and higher heart rate were independent predictors of LV systolic dysfunction and RWMA. Donor cause of death, cardiopulmonary resuscitation, and history of cocaine or methamphetamine use, smoking, and hypertension did not predict LV dysfunction or RWMA. In a multivariable model, after adjusting for donor age, size, and heart rate, female gender remained a strong independent predictor of LV systolic dysfunction (OR 5.75, 95% CI 1.76-18.76, p 0.004) and RWMA (OR 5.73, 95% CI 2.02-16.20, p 0.001). Conclusions: Female gender is associated with the presence of LV systolic dysfunction and RWMA in brain dead organ donors. Further studies assessing the reversibility of LV dysfunction and suitability of these organs for transplantation are required.