The importance of cold and warm cardiac ischemia for survival after heart transplantation

BACKGROUND: Ischemia time is a risk factor for mortality after heart transplantation that can be influenced by organizational factors such as transport arrangements and organ allocation. METHODS: We used the United Kingdom Cardiothoracic Transplant Audit database to analyze the outcome of 1491 first isolated orthotopic adult heart transplants performed between April 1995 and March 2004. Ischemia time and its components (transport time and surgical implant time) were related to 30-day mortality using a multivariable logistic regression model. RESULTS: The median total ischemia time increased from 171 min (interquartile range: 149-198) to 213 min (interquartile range: 181-256) during the study period (P