Elevated donor hemoglobin A1c does not impair early survival in cardiac transplant recipients.

Journal Article (Journal Article)

BACKGROUND: Orthotopic heart transplantation (OHT) is the gold-standard therapy for end-stage heart failure. An increasing deficit between suitable allograft availability and clinical demand for OHT exists. The role of donor diabetes mellitus (DM) on post-transplant recipient outcomes in OHT is controversial. The purpose of this study was to examine donor hemoglobin A1c (HbA1c) levels to identify the impact of donor glycemic control on recipient survival. METHODS: Adult OHT recipients with donor HbA1c data were identified in the UNOS database from 2010 to 2015. Recipients were stratified on the basis of donor glycemic status: Hyperglycemic-donor and euglycemic-donor cohorts were defined as HbA1c levels ≥6.5% and <6.5%, respectively. Outcomes were compared between unadjusted and propensity-matched hyperglycemic versus euglycemic donors. Primary end point was three-year survival. RESULTS: Of 5342 OHT recipients, 208 (3.89%) received an allograft from a hyperglycemic donor and 5134 (96.1%) received an allograft from a euglycemic donor. There was no significant difference in survival in the hyperglycemic group before (P=.87) or after (P=.78) propensity matching. CONCLUSIONS: No difference in four-year survival was noted in recipients who received allografts from hyperglycemic donors. These results suggest that recent cumulative donor glycemic status alone may not be an important predictor of recipient outcomes.

Full Text

Duke Authors

Cited Authors

  • Joseph, JT; Mulvihill, MS; Yerokun, BA; Bell, SM; Milano, CA; Hartwig, MG

Published Date

  • July 2017

Published In

Volume / Issue

  • 31 / 7

PubMed ID

  • 28470781

Electronic International Standard Serial Number (EISSN)

  • 1399-0012

Digital Object Identifier (DOI)

  • 10.1111/ctr.12995


  • eng

Conference Location

  • Denmark