Impact of Donor Hemodynamics on Recipient Survival in Heart Transplantation.

Autor: Fu S; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Inampudi C; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Ramu B; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Gregoski MJ; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC., Atkins J; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Jackson GR; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Celia A; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Griffin JM; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Silverman DN; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Judge DP; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., VAN Bakel AB; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Witer LJ; Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC., Kilic A; Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC., Houston BA; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC., Sauer AJ; St. Luke's Mid America Heart Institute, Kansas City, KS., Kittleson MM; Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA., Schlendorf KH; Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN., Cogswell RJ; Department of Medicine, Division of Cardiology, University of Minnesota School of Medicine, Minneapolis, MN., Tedford RJ; From the Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC. Electronic address: TedfordR@musc.edu.
Jazyk: angličtina
Zdroj: Journal of cardiac failure [J Card Fail] 2023 Sep; Vol. 29 (9), pp. 1288-1295. Date of Electronic Publication: 2023 May 23.
DOI: 10.1016/j.cardfail.2023.05.011
Abstrakt: Background: Heart transplantation is the gold-standard therapy for end-stage heart failure, but rates of donor-heart use remain low due to various factors that are often not evidence based. The impact of donor hemodynamics obtained via right-heart catheterization on recipient survival remains unclear.
Methods: The United Network for Organ Sharing registry was used to identify donors and recipients from September 1999-December 2019. Donor hemodynamics data were obtained and analyzed using univariate and multivariable logistical regression, with the primary endpoints being 1- and 5-year post-transplant survival.
Results: Of the 85,333 donors who consented to heart transplantation during the study period, 6573 (7.7%) underwent right-heart catheterization, of whom 5531 eventually underwent procurement and transplantation. Donors were more likely to undergo right-heart catheterization if they had high-risk criteria. Recipients who had donor hemodynamic assessment had 1- and 5-year survival rates similar to those without donor hemodynamic assessment (87% vs 86%, 1 year). Abnormal hemodynamics were common in donor hearts but did not impact recipient survival rates, even when risk-adjusted in multivariable analysis.
Conclusions: Donors with abnormal hemodynamics may represent an opportunity to expand the pool of viable donor hearts.
Competing Interests: Disclosures CI reports consulting relationships with Abbott. GRJ reports consulting relationships/honoraria with Respicardia. JMG reports consulting relationships with Eidos Therapeutics. DPJ reports consulting relationships with ADRx, Cytokinetics, Pfizer, and Tenaya Therapeutics, steering committee membership with Renovacor, and DSMB with Capricor. ABvB reports DSMB committee work for TransMedics and research support from CareDx. AK reports a consulting relationship with Abiomed and medical advisor for Medtronic. BAH reports consulting relationships with Medtronic and Bioventrix and has received research grant funding from Medtronic. AJS reports consulting relationships with Abbott, Medtronic, General Prognostics, Story Health, Impulse Dynamics, and Edwards Life Sciences, has received research grant funding from Abbott, General Prognostics, Impulse Dynamics, Endotronix, and Edwards Life Sciences and serves on steering committees for Boston Scientific, Abbott, General Prognostics, and Biotronik. RJC reports advisory board work for Medtronic and Abbott Lab and spousal employment at Medtronic. RJT reports consulting relationships with Medtronic, Abbott, Aria CV, Alleviant, Acceleron, Itamar, Edwards LifeSciences, Eidos Therapeutics, Lexicon Pharmaceuticals, Gradient, and United Therapeutics and is on a steering committee for Medtronic, Acceleron and Abbott, is on a research advisory board for Abiomed and also does hemodynamic core lab work for Actelion and Merck. All other listed authors have no disclosures to report.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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