BACKGROUND: Donor-recipient size match is traditionally assessed by body weight. We assessed the ability of 5 size match metrics-predicted heart mass (PHM), weight, height, body mass index (BMI) and body surface area (BSA)-to predict 1-year mortality after heart transplant and to assess the effect of size match on donor heart turn down for size. METHODS: The study cohort comprised 19,168 adult heart transplant recipients in the United Network for Organ Sharing registry between 2007 and 2016. Each size match metric was divided into 7 equally sized groups using the donor-recipient ratio for each metric. Single and multivariable Cox proportional hazard models for mortality 1 year after transplant were constructed. RESULTS: Recipients in the severely (donor-recipient PHM ratio 0.54-0.86) undersized group for PHM experienced increased mortality, with a hazard ratio of 1.34 (95% confidence interval, 1.13-1.59; p < 0.001). There was no increased risk of death at 1 year if donors were undersized for weight, height, BMI, or BSA. We found that 32% of heart offers turned down for donor size would be acceptable using a PHM threshold of 0.86 or greater and that 14% of offers accepted (most of which are female donor to male recipient) were below this threshold. CONCLUSIONS: PHM is the optimal donor-recipient size match metric for prediction of mortality after heart transplant. Many offers turned down for donor size were above the threshold for adequacy of size match by PHM identified, and thus, the use of PHM could improve donor heart utilization and post-transplant survival.
BACKGROUND:Donor-recipient size match is traditionally assessed by body weight. We assessed the ability of 5 size match metrics-predicted heart mass (PHM), weight, height, body mass index (BMI) and body surface area (BSA)-to predict 1-year mortality after heart transplant and to assess the effect of size match on donor heart turn down for size. METHODS: The study cohort comprised 19,168 adult heart transplant recipients in the United Network for Organ Sharing registry between 2007 and 2016. Each size match metric was divided into 7 equally sized groups using the donor-recipient ratio for each metric. Single and multivariable Cox proportional hazard models for mortality 1 year after transplant were constructed. RESULTS: Recipients in the severely (donor-recipient PHM ratio 0.54-0.86) undersized group for PHM experienced increased mortality, with a hazard ratio of 1.34 (95% confidence interval, 1.13-1.59; p < 0.001). There was no increased risk of death at 1 year if donors were undersized for weight, height, BMI, or BSA. We found that 32% of heart offers turned down for donor size would be acceptable using a PHM threshold of 0.86 or greater and that 14% of offers accepted (most of which are female donor to male recipient) were below this threshold. CONCLUSIONS: PHM is the optimal donor-recipient size match metric for prediction of mortality after heart transplant. Many offers turned down for donor size were above the threshold for adequacy of size match by PHM identified, and thus, the use of PHM could improve donor heart utilization and post-transplant survival.
Authors: Kiran K Khush; Wida S Cherikh; Daniel C Chambers; Michael O Harhay; Don Hayes; Eileen Hsich; Bruno Meiser; Luciano Potena; Amanda Robinson; Joseph W Rossano; Aparna Sadavarte; Tajinder P Singh; Andreas Zuckermann; Josef Stehlik Journal: J Heart Lung Transplant Date: 2019-08-10 Impact factor: 10.247
Authors: Joseph W Rossano; Tajinder P Singh; Wida S Cherikh; Daniel C Chambers; Michael O Harhay; Don Hayes; Eileen Hsich; Kiran K Khush; Bruno Meiser; Luciano Potena; Alice E Toll; Aparna Sadavarte; Andreas Zuckermann; Josef Stehlik Journal: J Heart Lung Transplant Date: 2019-08-10 Impact factor: 10.247
Authors: Benjamin Hoemann; Hiroo Takayama; Douglas L Jennings; Jiho Han; Masahiko Ando; Susan Restaino; Paolo Colombo; Maryjane Farr; Yoshifumi Naka; Koji Takeda Journal: Clin Transplant Date: 2020-01-29 Impact factor: 2.863
Authors: Fabiana G Marcondes-Braga; Jefferson L Vieira; João David de Souza Neto; Gustavo Calado; Silvia Moreira Ayub-Ferreira; Fernando Bacal; Nadine Clausell Journal: Arq Bras Cardiol Date: 2020-12 Impact factor: 2.000
Authors: María Dolores García-Cosío; Francisco González-Vilchez; Raquel López-Vilella; Eduardo Barge-Caballero; Manuel Gómez Bueno; Manuel Martínez-Selles; Jose María Arizón; Diego Rangel Sousa; José González-Costello; Sonia Mirabet; Félix Pérez-Villa; Beatriz Díaz Molina; Gregorio Rábago; Ana Portolés Ocampo; Luis de la Fuente Galán; Iris Garrido; Juan F Delgado Journal: Front Cardiovasc Med Date: 2021-02-25