Haider J Warraich1, Di Lu2, Stacy Cobb2, Lauren B Cooper3, Adam DeVore4, Chetan B Patel5, Paul B Rosenberg5, Jacob N Schroder6, Mani A Daneshmand6, Carmelo A Milano6, Adrian F Hernandez4, Joseph G Rogers4, Robert J Mentz4. 1. Department of Medicine (Cardiology Division), Duke University Medical Center, Durham, NC, United States; Duke Clinical Research Institute, Durham, NC, United States. Electronic address: haider.warraich@duke.edu. 2. Duke Clinical Research Institute, Durham, NC, United States. 3. Department of Medicine (Cardiology Division), Duke University Medical Center, Durham, NC, United States; Inova Heart & Vascular Institute, Falls Church, VA, United States. 4. Department of Medicine (Cardiology Division), Duke University Medical Center, Durham, NC, United States; Duke Clinical Research Institute, Durham, NC, United States. 5. Department of Medicine (Cardiology Division), Duke University Medical Center, Durham, NC, United States. 6. Department of Surgery, Duke University Medical Center, Durham, NC, United States.
Abstract
BACKGROUND: Deaths from drug intoxication have increased in the United States but outcomes of recipients of orthotopic heart transplantation (OHT) from these donors are not well characterized. METHODS: We performed a retrospective analysis of the United Network for Organ Sharing's STAR database between January 2000 and March 2014 and assessed mortality and retransplantation using adjusted Cox models by mechanism of donor death. RESULTS: Of the 31,660 OHTs from 2000 to 2014, 1233 (3.9%) were from drug intoxication. These donors were more likely to be female, white, with greater tobacco use and higher BMI compared to donors who died of other mechanisms. Drug intoxication accounted for 1.1% of OHT donors in 2000 and 6.2% in March 2014. No significant difference was observed in 10-year mortality (adjusted hazard ratio [HR], 95% confidence interval [CI]: 0.99, 0.87-1.13), 10-year retransplantation (adjusted HR 0.84, 0.49-1.41) or 1-year and 3-year rehospitalization with other mechanisms of death compared to drug intoxication. CONCLUSION: There has been a large increase in OHT donors who die of drug intoxication in the United States. OHT outcomes from these donors are similar to those dying from other mechanisms. These data have important implications for donor selection in context of the ongoing opioid epidemic.
BACKGROUND: Deaths from drug intoxication have increased in the United States but outcomes of recipients of orthotopic heart transplantation (OHT) from these donors are not well characterized. METHODS: We performed a retrospective analysis of the United Network for Organ Sharing's STAR database between January 2000 and March 2014 and assessed mortality and retransplantation using adjusted Cox models by mechanism of donor death. RESULTS: Of the 31,660 OHTs from 2000 to 2014, 1233 (3.9%) were from drug intoxication. These donors were more likely to be female, white, with greater tobacco use and higher BMI compared to donors who died of other mechanisms. Drug intoxication accounted for 1.1% of OHT donors in 2000 and 6.2% in March 2014. No significant difference was observed in 10-year mortality (adjusted hazard ratio [HR], 95% confidence interval [CI]: 0.99, 0.87-1.13), 10-year retransplantation (adjusted HR 0.84, 0.49-1.41) or 1-year and 3-year rehospitalization with other mechanisms of death compared to drug intoxication. CONCLUSION: There has been a large increase in OHT donors who die of drug intoxication in the United States. OHT outcomes from these donors are similar to those dying from other mechanisms. These data have important implications for donor selection in context of the ongoing opioid epidemic.
Authors: David A Baran; Justin Lansinger; Ashleigh Long; John M Herre; Amin Yehya; Edward J Sawey; Amit P Badiye; Wayne Old; Jack Copeland; Kelly Stelling; Hannah Copeland Journal: Circ Heart Fail Date: 2021-07-28 Impact factor: 8.790