Heart transplantation provides a substantial survival benefit for selected patients with advanced heart failure, achieving a 1 year survival rate of ≥80%. Up to two thirds of hearts offered for transplantation are rejected before detailed organ inspection as being likely to fail if transplanted. The decision to discount these organs is based on clinical factors (e.g. blood pressure, electrocardiographic changes, prior cardiopulmonary resuscitation, drug history, history of hypertension and the need for inotropic support). However, none of these factors necessarily preclude successful transplantation. Thus, there is a pool of unused hearts, for which permission for heart donation has been granted, from which additional transplants could be generated if we could be more confident about their current and future function. My research prospectively validated a definition of primary allograft dysfunction following heart transplantation that is suitable for use in multicentre studies. I then investigated the role of biomarkers in the evaluation of potential cardiac donors with objective of increasing the number of donor hearts that will be assessed by direct inspection. This lead to the design of a scoring system to guide donor evaluation.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:659146 |
| Date | January 2015 |
| Creators | Dronavalli, Vamsidhar Bharadwaz |
| Publisher | University of Birmingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.bham.ac.uk//id/eprint/6096/ |
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