Purpose: Ischemic time (IT) is an independent risk factor for poor functional exercise capacity (FEC) following orthotopic heart transplantation (OHT). The OHT recipient’s post-transplant FEC (peak VO2) is directly associated with improved quality of life. However, there is debate in the literature about the deleterious impact of extended IT on FEC following OHT.
Methods: Fifteen OHT recipients (14 men and 1 woman; < 3 months from OHT) performed a symptom-limited graded CPET where peak VO2 was measured in an outpatient cardiac rehabilitation. IT was obtained from the anesthesia post-operative note. VO2 and IT values were dichotomized based on previous literature; high, ≥14 mL/kg/min (or ≥12 mL/kg/min if taking a beta blocker), and low, /kg/min (or /kg/min if taking a beta blocker), and short, long, ≥180 min, respectively. A Fisher’s Exact Test was used to determine if extended IT is associated with decreased FEC.
Results: The median (IQR) recipient and donor characteristics are presented in Table 3. The Fisher’s Exact Test yielded a p value of 0.62.
Conclusions: Extended IT was not associated with decreased FEC in the months following OHT in those recipients who survived to discharge with stamina sufficient to engage in outpatient cardiac rehabilitation. The wider IQR of peak VO2 in recipients with extended IT, despite the higher number of recipients, suggests that while properly selected allografts are able to tolerate a longer IT without compromising intermediate term FEC, this is not a homogenous correlation and other peri-transplant factors may modify FEC.
Date of publication
Dr. Arturo A Arce-Esquivel, Dr. Cheryl Cooper and Dr. Jenny Adams
Masters of Science in Kinesiology
Brown, Katelyn D., "IMPACT OF ISCHEMIC TIME ON FUNCTIONAL EXERCISE CAPACITY AFTER ORTHOTOPIC HEART TRANSPLANTATION" (2019). Health and Kinesiology Theses. Paper 18.