Heart donation: the New Zealand experience, 1987-1996

AIMS: To audit all donor hearts offered to our unit, assess the outcome, identify factors which might enhance the acceptance rate and provide data on which to base and modify acceptance criteria. METHODS: Demographic, clinical and outcome data were collected retrospectively and analysed for all patients in whom brain death had been established and permission for organ donation obtained from the family prior to referral to the transplant donor coordinator. RESULTS: Over a nine year period (1987-96) 267 hearts were offered for transplantation. The mean donor age was 31.2 years (2-72), 163 being male and 104 female. The cause of death was secondary to trauma in 52%, neurological in 44% and due to hypoxia in 4%. The mean donor weight was 68 kg and the distribution of ABO blood group similar to the New Zealand population. Seventy-six hearts (28%) were implanted. Of the 191 not implanted no suitable recipient was available for 98 (51%) according to blood group and body weight criteria, 38 donors (20%) were medically unsuitable, 37 (19%) were declined because of donor age, 16 (8%) because of a markedly abnormal echocardiogram and 2 (1%) for logistical reasons. CONCLUSIONS: Enhanced efforts are needed to increase public awareness of the benefits of organ donation. However, a greater number of heart transplants may be achieved by increasing the recipient pool.