Correlation between Ischemia Time and Primary Graft Disfunction in Cardiac Transplant at a Brazilian Center

Abstract

Purpose Primary graft dysfunction (PGD) has been associated with donor and recipient characteristics. The ischemia reperfusion injury is likely to play an important role in the development of PGD and is directly related to the ischemic time. This study aims to compare the incidence of PGD and 30 days mortality in cardiac transplantation recipients according to the ischemia time. Methods Patients that underwent heart transplant from January 2014 to September 2018 in Instituto de Medicina Integral Professor Fernando Figueira (IMIP) were included. The myocardium preservation technique included a single dose of cold HTK cardioplegia (20ml/kg) in the donor heart, and a transport temperature aimed between 0 - 4 oC. The standard technique for the transplant was the orthotopic bicaval. Reperfusion was performed after all the anastomosis were finished. PGD was defined as a hard outcome of death in the first 30 days due to heart failure, not related to infection, rejection or surgical issues. Results A total of 125 patients were enrolled during the study time frame, 97 (77,6%) had an ischemia time Conclusion As seen in the current literature, a longer ischemia time was strongly related to PGD. Mortality also trended to be higher in this group, without statistical significance. A greater number of enrolled patients and more parameters to better define PGD are needed to confirm in a stronger way the data found.