Effects of donor pre-treatment with dopamine on survival after heart transplantation: a cohort study of heart transplant recipients nested in a randomized controlled multicenter trial.
Benck U, Hoeger S, et al.Journal of the American College of Cardiology 58(17): 1768-1777, 2011
Aims
To determine the outcome of cardiac allograft from multiorgan donors who were pre-treated with low-dose dopamine.
Interventions
Donors pre-treated with low-dose dopamine versus no dopamine treatment.
Participants
93 heart transplant recipients.
Outcomes
Post-transplant left ventricular function, requirement of a left ventricular assist device or biventricular assist device, need for hemofiltration, acute rejection, and graft/patients survival.
Follow-up
3 years
CET Conclusions
This is a posthoc analysis of the outcome of cardiac allografts from donors enrolled in a randomised trial of donor pre-treatment with dopamine in kidney transplantation. Thus this study has limited validity but has produced an interesting result, namely that there is improved survival of recipients where the donor received dopamine before retrieval. There was no evidence that dopamine pre-treatment of the donor harmed the subsequent cardiac allograft and, as the authors suggest, these results fully justify planning a prospective randomised trial of dopamine pre-treatment of heart beating multi-organ donors.
Data analysis
Per protocol analysis
Quality notes
This is a retrospective analysis of a previous publication of the same RCT: Schnuelle P, Gottmann U, Hoeger S, et al. Effects of donor pretreatment with dopamine on graft function after kidney transplantation: a randomized controlled trial. JAMA 2009;302:1067–75. The methodological quality assessment was based on the previous publication.
Trial registration
NCT00115115 (ClinicalTrials.gov)