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Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis.

Publication ,  Journal Article
Jawitz, OK; Raman, V; Barac, YD; Anand, J; Patel, CB; Mentz, RJ; DeVore, AD; Milano, C
Published in: J Thorac Cardiovasc Surg
April 2020

OBJECTIVES: We hypothesized that an increased duration of donor brain death may worsen survival following orthotopic heart transplantation. METHODS: The United Network for Organ Sharing Registry was queried for first-time, adult recipients of heart transplant from 2006 to 2018. Cox proportional hazards with penalized smooth splines was used to stratify patients based on donor brain death interval: shorter (<22 hours), reference (22-42 hours), and longer (>42 hours). Overall survival was estimated using Kaplan-Meier and Cox proportional hazards models. RESULTS: A total of 22,960 patients met study criteria (9.2% shorter, 55.0% reference, and 35.8% longer). Longer brain death duration recipients were more likely to have a later year of transplant and have a mechanical bridge to transplant, whereas longer duration donors were more likely to be black and die of anoxia compared with shorter duration and reference donors. Compared with reference, neither shorter (hazard ratio, 1.02; 95% confidence interval, 0.94-1.12) nor longer donor brain death interval (hazard ratio, 1.01; 95% CI, 0.94-1.08) was associated with posttransplant survival in either unadjusted or multivariable analyses (both P values >0.6). CONCLUSIONS: Longer duration of brain death was not associated with worse survival following heart transplantation. Donors with prolonged interval of brain death should not necessarily be excluded based on brain death period alone.

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Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

April 2020

Volume

159

Issue

4

Start / End Page

1345 / 1353.e2

Location

United States

Related Subject Headings

  • Tissue and Organ Procurement
  • Survival Rate
  • Respiratory System
  • Registries
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
  • Heart Transplantation
 

Citation

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Jawitz, O. K., Raman, V., Barac, Y. D., Anand, J., Patel, C. B., Mentz, R. J., … Milano, C. (2020). Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis. J Thorac Cardiovasc Surg, 159(4), 1345-1353.e2. https://doi.org/10.1016/j.jtcvs.2019.04.060
Jawitz, Oliver K., Vignesh Raman, Yaron D. Barac, Jatin Anand, Chetan B. Patel, Robert J. Mentz, Adam D. DeVore, and Carmelo Milano. “Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis.J Thorac Cardiovasc Surg 159, no. 4 (April 2020): 1345-1353.e2. https://doi.org/10.1016/j.jtcvs.2019.04.060.
Jawitz OK, Raman V, Barac YD, Anand J, Patel CB, Mentz RJ, et al. Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis. J Thorac Cardiovasc Surg. 2020 Apr;159(4):1345-1353.e2.
Jawitz, Oliver K., et al. “Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis.J Thorac Cardiovasc Surg, vol. 159, no. 4, Apr. 2020, pp. 1345-1353.e2. Pubmed, doi:10.1016/j.jtcvs.2019.04.060.
Jawitz OK, Raman V, Barac YD, Anand J, Patel CB, Mentz RJ, DeVore AD, Milano C. Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis. J Thorac Cardiovasc Surg. 2020 Apr;159(4):1345-1353.e2.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

April 2020

Volume

159

Issue

4

Start / End Page

1345 / 1353.e2

Location

United States

Related Subject Headings

  • Tissue and Organ Procurement
  • Survival Rate
  • Respiratory System
  • Registries
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
  • Heart Transplantation