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.
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 donordiabetes 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.
Authors: Brian Lima; Keshava Rajagopal; Rebecca P Petersen; Ashish S Shah; Beth Soule; G Michael Felker; Joseph G Rogers; Andrew J Lodge; Carmelo A Milano Journal: Circulation Date: 2006-07-04 Impact factor: 29.690
Authors: L D Sharples; N Caine; P Mullins; J P Scott; E Solis; T A English; S R Large; P M Schofield; J Wallwork Journal: Transplantation Date: 1991-08 Impact factor: 4.939
Authors: D Freimark; L S Czer; D Admon; I Aleksic; M Valenza; P Barath; D Harasty; C Queral; C G Azen; C Blanche Journal: J Heart Lung Transplant Date: 1994 Nov-Dec Impact factor: 10.247
Authors: Sebastian Giwa; Jedediah K Lewis; Luis Alvarez; Robert Langer; Alvin E Roth; George M Church; James F Markmann; David H Sachs; Anil Chandraker; Jason A Wertheim; Martine Rothblatt; Edward S Boyden; Elling Eidbo; W P Andrew Lee; Bohdan Pomahac; Gerald Brandacher; David M Weinstock; Gloria Elliott; David Nelson; Jason P Acker; Korkut Uygun; Boris Schmalz; Brad P Weegman; Alessandro Tocchio; Greg M Fahy; Kenneth B Storey; Boris Rubinsky; John Bischof; Janet A W Elliott; Teresa K Woodruff; G John Morris; Utkan Demirci; Kelvin G M Brockbank; Erik J Woods; Robert N Ben; John G Baust; Dayong Gao; Barry Fuller; Yoed Rabin; David C Kravitz; Michael J Taylor; Mehmet Toner Journal: Nat Biotechnol Date: 2017-06-07 Impact factor: 54.908
Authors: Benjamin A Goldstein; Laine Thomas; Jonathan G Zaroff; John Nguyen; Rebecca Menza; Kiran K Khush Journal: Epidemiology Date: 2016-07 Impact factor: 4.822
Authors: Elizabeth A Swanson; Tony Adams; Madhukar S Patel; Salvador De La Cruz; Michael Hutchens; Kiran Khush; Mitchell B Sally; Claus U Niemann; Tahnee Groat; Darren J Malinoski Journal: J Am Coll Surg Date: 2020-06-17 Impact factor: 6.113
Authors: Kiran K Khush; John Nguyen; Benjamin A Goldstein; Dana P McGlothlin; Jonathan G Zaroff Journal: J Heart Lung Transplant Date: 2014-10-24 Impact factor: 10.247