Donor predictors of allograft use and recipient outcomes after heart transplantation.

Published

Journal Article

BACKGROUND: Despite a national organ-donor shortage and a growing population of patients with end-stage heart disease, the acceptance rate of donor hearts for transplantation is low. We sought to identify donor predictors of allograft nonuse, and to determine whether these predictors are in fact associated with adverse recipient post-transplant outcomes. METHODS AND RESULTS: We studied a cohort of 1872 potential organ donors managed by the California Transplant Donor Network from 2001 to 2008. Forty-five percent of available allografts were accepted for heart transplantation. Donor predictors of allograft nonuse included age >50 years, female sex, death attributable to cerebrovascular accident, hypertension, diabetes mellitus, a positive troponin assay, left-ventricular dysfunction and regional wall motion abnormalities, and left-ventricular hypertrophy. For hearts that were transplanted, only donor cause of death was associated with prolonged recipient hospitalization post-transplant, and only donor diabetes mellitus was predictive of increased recipient mortality. CONCLUSIONS: Whereas there are many donor predictors of allograft discard in the current era, these characteristics seem to have little effect on recipient outcomes when the hearts are transplanted. Our results suggest that more liberal use of cardiac allografts with relative contraindications may be warranted.

Full Text

Duke Authors

Cited Authors

  • Khush, KK; Menza, R; Nguyen, J; Zaroff, JG; Goldstein, BA

Published Date

  • March 2013

Published In

Volume / Issue

  • 6 / 2

Start / End Page

  • 300 - 309

PubMed ID

  • 23392789

Pubmed Central ID

  • 23392789

Electronic International Standard Serial Number (EISSN)

  • 1941-3297

Digital Object Identifier (DOI)

  • 10.1161/CIRCHEARTFAILURE.112.000165

Language

  • eng

Conference Location

  • United States