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(Circulation. 2002;106:836.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Consensus Conference Report

Maximizing Use of Organs Recovered From the Cadaver Donor: Cardiac Recommendations
March 28–29, 2001, Crystal City, Va

Jonathan G. Zaroff, MD, Conference Co-Chair; Bruce R. Rosengard, MD, Conference Co-Chair; William F. Armstrong, MD; Wayne D. Babcock, BSN; Anthony D’Alessandro, MD; G. William Dec, MD; Niloo M. Edwards, MD; Robert S. Higgins, MD; Valluvan Jeevanandum, MD; Myron Kauffman, MD; James K. Kirklin, MD; Stephen R. Large, MD; Daniel Marelli, MD; Tammie S. Peterson, RN; W. Steves Ring, MD; Robert C. Robbins, MD; Stuart D. Russell, MD; David O. Taylor, MD; Adrian Van Bakel, MD; John Wallwork, MB; James B. Young, MD

From UCSF Medical Center (J.G.Z.), San Francisco, Calif; University of Pennsylvania (B.R.R.), Philadelphia; University of Michigan (W.F.A.), Ann Arbor; California Transplant Donor Network (W.D.B.), Oakland, Calif; University of Wisconsin (A.D.A.), Madison; Massachusets General Hospital (G.W.D.), Boston; Columbia University (N.M.E.), New York, NY; Medical College of Virginia (R.S.H.), Richmond; University of Chicago (V.J.), Ill; United Network for Organ Sharing (M.K.), Richmond, Va; University of Alabama at Birmingham (J.K.K.); Papworth Hospital (S.R.L., J.W.), Cambridge, UK; University of California (D.M.), Los Angeles; Southwest Transplant Alliance (T.S.P.), Dallas, Tex; University of Texas Southwestern Medical Center (W.S.R.), Dallas; Stanford University (R.C.R.), Stanford, Calif; Duke University (S.D.R.), Durham, NC; Cleveland Clinic Foundation (D.O.T., J.B.Y.), Ohio; Medical University of South Carolina (A.V.B.), Charleston.

Correspondence to Jonathan G. Zaroff, MD, UCSF Medical Center, 505 Parnassus Ave, Moffitt Suite 1176, San Francisco, CA 94143-0124. E-mail zaroff{at}medicine.ucsf.edu

The shortage of available donor hearts continues to limit cardiac transplantation. For this reason, strict criteria have limited the number of patients placed on the US waiting list to 6000 to 8000 per year. Because the number of available donor hearts has not increased beyond 2500 per year, the transplant waiting list mortality rate remains substantial. Suboptimal and variable utilization of donor hearts has compounded the problem in the United States. In 1999, the average donor yield from 55 US regions was 39%, ranging from 19% to 62%. This report provides the detailed cardiac recommendations from the conference on "Maximizing Use of Organs Recovered From the Cadaver Donor" held March 28 to 29, 2001, in Crystal City, Va. The specific objective of the report is to provide recommendations to improve the evaluation and successful utilization of potential cardiac donors. The report describes the accuracy of current techniques such as echocardiography in the assessment of donor heart function before recovery and the impact of these data on donor yield. The rationale for and specific details of a donor-management pathway that uses pulmonary artery catheterization and hormonal resuscitation are provided. Administrative recommendations such as enhanced communication strategies among transplant centers and organ-procurement organizations, financial incentives for organ recovery, and expansion of donor database fields for research are also described.

Key Words: transplantation • resuscitation • catheterization • echocardiography

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