Table 2.
Baseline characteristics.
| Total (n = 111) | No or mild isolated RV failure (n = 87) | Moderate isolated RV failure (n = 14) | Severe isolated RV failure (n = 10) | P value | |
|---|---|---|---|---|---|
| Recipients | |||||
| Age (years) | 41 ± 16 | 40 ± 16 | 47 ± 13 | 44 ± 18 | 0.284 |
| Female (n, %) | 32 (28%) | 26 (30%) | 1 (7%) | 5 (50%) | 0.060 |
| BMI (kg/m2) | 20.2 ± 3.5 | 20.2 ± 3.6 | 20.2 ± 2.8 | 20.0 ± 3.3 | 0.981 |
| Congenital heart disease (n, %) | 4 (4%) | 4 (5%) | 0 (0%) | 0 (0%) | 1.000 |
| BUN (mg/dL) | 28.5 ± 15.8 | 26.5 ± 15.0 | 30.4 ± 14.1 | 43.3 ± 18.3 | 0.005* |
| Creatinine (mg/dL) | 1.3 ± 1.1 | 1.3 ± 1.3 | 1.5 ± 0.4 | 1.4 ± 0.4 | 0.886 |
| Direct bilirubin (mg/dL) | 1.2 ± 1.2 | 1.0 ± 1.0 | 1.0 ± 0.6 | 2.8 ± 1.9 | < 0.001* |
| Diabetes (n, %) | 12 (11%) | 10 (12%) | 2 (14%) | 0 (0%) | 0.642 |
| INTERMACS profile 1–3 (n, %) | 26 (23%) | 22 (25%) | 2 (14%) | 2 (20%) | 0.784 |
| Inotrope dependence (n, %) | 21 (19%) | 17 (20%) | 1 (7%) | 3 (30%) | 0.373 |
| Pre-operative MCS (n, %) | 8 (7%) | 8 (9%) | 0 (0%) | 0 (0%) | 0.651 |
| ECMO | 7 (6%) | ||||
| Bi-VAD | 1 (1%) | ||||
| Hemoglobin < 10 g/dl (n, %) | 11 (10%) | 9 (10%) | 1 (7%) | 1 (10%) | 1.000 |
| Direct bilirubin > 1.5 mg/dl (n, %) | 26 (24%) | 16 (19%) | 2 (14%) | 8 (80%) | < 0.001* |
| BUN > 43 mg/dl (n, %) | 19 (17%) | 10 (12%) | 3 (21%) | 6 (60%) | 0.001* |
| Creatinine > 1.8 mg/dl (n, %) | 15 (14%) | 10 (12%) | 2 (14%) | 3 (30%) | 0.200 |
| Pre-transplant RAP (mmHg) | 10.8 ± 6.0 | 10.5 ± 5.6 | 9.7 ± 7.2 | 14.8 ± 7.0 | 0.077 |
| Pre-transplant TPG (mmHg) | 9.3 ± 4.8 | 9.6 ± 5.0 | 8.0 ± 3.5 | 8.9 ± 4.0 | 0.516 |
| Pre-transplant PVR (Wood units) | 3.1 ± 2.0 | 3.2 ± 2.2 | 3.0 ± 1.4 | 3.2 ± 2.0 | 0.947 |
| Pre-transplant PVR > 3 Wood units (n, %) | 44 (47%) | 32 (45%) | 7 (50%) | 5 (56%) | 0.828 |
| Pre-transplant TPG > 12 mmHg (n, %) | 21 (21%) | 18 (24%) | 0 (0%) | 3 (30%) | 0.065 |
| Pre-transplant RAP > 12 mmHg (n, %) | 37 (33%) | 29 (33%) | 2 (14%) | 6 (60%) | 0.079 |
| Pre-transplant PA SaO2 (%) | 64.3 ± 12.7 | 65.0 ± 13.6 | 59.0 ± 8.0 | 65.3 ± 7.6 | 0.504 |
| Donor | |||||
| Age (years) | 28 ± 9 | 27 ± 9 | 30 ± 9 | 30.0 ± 8 | 0.361 |
| Female (n, %) | 13 (12%) | 12 (13%) | 0 (0%) | 1 (10%) | 0.365 |
| BMI (kg/m2) | 23.0 ± 3.0 | 22.9 ± 3.0 | 24.1 ± 3.0 | 23.0 ± 2.7 | 0.336 |
| Inotrope score‡ | 19.8 ± 17.9 | 19.7 ± 16.3 | 27.3 ± 7.3 | 15.5 ± 14.3 | 0.580 |
| History of chest compression (n, %) | 3 (2.7%) | 2 (2.3%) | 1 (7.1%) | 0 (0%) | 0.521 |
| Donor intracranial hemorrhage (n, %) | 20 (18%) | 14 (16%) | 3 (21.4%) | 3 (30%) | 0.405 |
| Procedural characteristics | |||||
| RADIAL score¶ | 1.7 ± 1.0 | 1.7 ± 1.0 | 1.5 ± 0.9 | 1.9 ± 1.0 | 0.647 |
| RADIAL score > 2 (n, %) | 22 (19.8%) | 18 (20.7%) | 2 (14.3%) | 2 (20%) | 0.913 |
| Female donor to male recipient (n, %) | 6 (5%) | 6 (7%) | 0 (0%) | 0 (0%) | 0.766 |
| Undersized donor (n, %) | 29 (26%) | 23 (26%) | 3 (21%) | 3 (30%) | 0.932 |
| Crossed ABO blood group (n, %) | 29 (26%) | 21 (24%) | 6 (43%) | 2 (20%) | 0.339 |
| Ischemic time > 240 min (n, %) | 56 (51%) | 45 (52%) | 7 (50%) | 4 (40%) | 0.781 |
| Ischemic time (min) | 226 ± 63 | 229 ± 7 | 208 ± 17 | 224 ± 20 | 0.528 |
| Post-operative medical therapy | |||||
| Nitric oxide use (%) | 30 (27%) | 14 (16%) | 6 (43%) | 10 (100%) | < 0.001 |
| Nitric oxide (ppm)** | 38 ± 19 | 30 ± 5 | 44 ± 8 | 47 ± 6 | 0.060 |
| Levosimadan (% use) | 16 (1.4%) | 10 (12%) | 3 (21%) | 3 (30%) | 0.209 |
| Epinephrine (% use) | 74 (67%) | 52 (60%) | 13 (93%) | 9 (90%) | < 0.001 |
| Norepinephrine (% use) | 8 (7%) | 1 (1%) | 3 (21%) | 4 (40%) | < 0.001 |
| Dobutamine (% use) | 64 (58%) | 46(53%) | 9 (64%) | 9 (90%) | 0.045 |
| Dopamine (% use) | 44 (40%) | 30 (35%) | 9 (64%) | 5 (50%) | 0.087 |
| Milrinone (% use) | 72 (66%) | 53 (61%) | 12 (86%) | 7 (70%) | 0.150 |
| Isoproterenol (% use) | 53 (49%) | 40 (48%) | 7 (50%) | 6 (60%) | 0.758 |
Bi-VAD biventricular assisted device, BMI body mass index, BUN blood urea nitrogen, INTERMACS Interagency Registry for Mechanically Assisted Circulatory Support, MCS mechanical circulatory support, PA pulmonary artery, PVR pulmonary vascular resistance, RAP right atrial pressure, RV right ventricular, SaO2 oxygen saturation, TPG transpulmonary pressure gradient.
*P value < 0.05 is statistical significance.
‡Inotropic score = dopamine (× 1) + dobutamine (× 1) + milrinone (× 15) + epinephrine (× 100) + norepinephrine (× 100) with each drug dose in microgram/kilogram/minute.
¶RADIAL score = Right atrial pressure ≥ 10 mmHg, recipient Age ≥ 60 years, Diabetes mellitus, Inotrope dependence, donor Age ≥ 30 years, Length of ischemic time ≥ 240 min.
**Post-operative nitric oxide doses were calculated by mean doses in ppm during post-operative day 0–3.