Joshua Newman1, Max Liebo1, Brian D Lowes2, Haseeb Ilias Basha1, Yael Peled3,4, Emily Cendrowski1, Ronald Zolty2, Dylan Douglas1, John Y Um5, Edwin McGee6, Alain Heroux1, Eugenia Raichlin1,2. 1. Department of Cardiology, Loyola University Medical Center, Maywood, Illinois. 2. Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska. 3. The Olga and Lev Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel. 4. The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Department of Cardiothoracic Surgery, University of Nebraska Medical Center, Omaha, Nebraska. 6. Department of Cardiothoracic Surgery, Loyola University Medical Center, Maywood, Illinois.
Abstract
BACKGROUND: Current guidelines recommend against the use of hearts from donors that abuse alcohol. We explored the effect of donor alcohol abuse (AA) on cardiac allograft function and outcomes in heart transplant (HTx) recipients. METHODS: Overall, 370 HTx recipients were divided into two groups: (a) the alcoholic donor group (AD, n = 58) and (b) the non-alcoholic donor group (NAD, n = 312). RESULTS: Recipients in the AD group had a slower heart rate (86 ± 13 vs 93 ± 13, P = 0.004) and an increased incidence of early atrial fibrillation (AF) (30% vs 11%, P = 0.003). Echocardiographic left ventricular mass was higher among alcoholic donors (171.7 ± 66.7 vs 151.6 ± 54.7, P = 0.02). This difference remained present 1 year following HTx (185 ± 43 vs 166 ± 42, P = 0.007). E/E' was higher in the AD group (9.5 ± 3.9 vs 8.4 ± 2.9, P = 0.04) and a larger number of AD recipients had a ventilatory equivalent for VCO2 > 34 (50% vs 31%, P = 0.04) on cardiopulmonary exercise test. There was no significant difference in rejection, cardiac allograft vasculopathy (CAV), or survival between the groups. CONCLUSIONS: Our data suggest that donor AA does not impact rejection, CAV, or intermediate-term survival, but may cause increased incidence of post-HTx AF and impaired cardiac allograft diastolic function.
BACKGROUND: Current guidelines recommend against the use of hearts from donors that abuse alcohol. We explored the effect of donoralcohol abuse (AA) on cardiac allograft function and outcomes in heart transplant (HTx) recipients. METHODS: Overall, 370 HTx recipients were divided into two groups: (a) the alcoholic donor group (AD, n = 58) and (b) the non-alcoholic donor group (NAD, n = 312). RESULTS: Recipients in the AD group had a slower heart rate (86 ± 13 vs 93 ± 13, P = 0.004) and an increased incidence of early atrial fibrillation (AF) (30% vs 11%, P = 0.003). Echocardiographic left ventricular mass was higher among alcoholic donors (171.7 ± 66.7 vs 151.6 ± 54.7, P = 0.02). This difference remained present 1 year following HTx (185 ± 43 vs 166 ± 42, P = 0.007). E/E' was higher in the AD group (9.5 ± 3.9 vs 8.4 ± 2.9, P = 0.04) and a larger number of AD recipients had a ventilatory equivalent for VCO2 > 34 (50% vs 31%, P = 0.04) on cardiopulmonary exercise test. There was no significant difference in rejection, cardiac allograft vasculopathy (CAV), or survival between the groups. CONCLUSIONS: Our data suggest that donor AA does not impact rejection, CAV, or intermediate-term survival, but may cause increased incidence of post-HTx AF and impaired cardiac allograft diastolic function.
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