Influence of donor age and donor-recipient age difference on intimal hyperplasia in pediatric patients with young and adult donors vs. adult patients after heart transplantation.

Autor: Ulrich S; Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital, LMU Munich, Munich, Germany., Arnold L; Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital, LMU Munich, Munich, Germany., Michel S; Department of Heart Surgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany., Tengler A; Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital, LMU Munich, Munich, Germany., Rosenthal L; Department of Heart Surgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany., Hausleiter J; Department of Medicine I, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany., Mueller CS; Department of Heart Surgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany., Schnabel B; Department of Heart Surgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany., Stark K; Department of Medicine I, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany., Rizas K; Department of Medicine I, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany., Grabmaier U; Department of Medicine I, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany., Mehilli J; Department of Medicine I, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.; Medizinische Klinik I, Landshut-Achdorf Hospital, Landshut, Germany., Jakob A; Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital, LMU Munich, Munich, Germany., Fischer M; Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital, LMU Munich, Munich, Germany., Birnbaum J; Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital, LMU Munich, Munich, Germany., Hagl C; Department of Heart Surgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany., Massberg S; Department of Medicine I, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany., Haas N; Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital, LMU Munich, Munich, Germany., Pozza RD; Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital, LMU Munich, Munich, Germany., Orban M; Department of Medicine I, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany. Madeleine.Orban@med.uni-muenchen.de.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany. Madeleine.Orban@med.uni-muenchen.de.
Jazyk: angličtina
Zdroj: Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2024 Jun 24. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1007/s00392-024-02477-4
Abstrakt: Aim: Optimal selection and allocation of donor hearts is a relevant aspect in transplantation medicine. Donor age and cardiac allograft vasculopathy (CAV) affect post-transplant mortality. To what extent donor age impacts intimal hyperplasia (CAV IH ) in pediatric and adult patients after heart transplantation (HTx) is understudied.
Methods: In a cohort of 98 HTx patients, 58 pediatric (24.1% with adult donors) and 40 adult patients, we assessed the effect of donor age and donor-recipient age difference (D-R) on the continuous parameter of maximal intima thickness (mIT) in optical coherence tomography. We evaluated their predictive value regarding higher mIT and the prevalence of CAV IH , defined as mIT > 0.3 mm, and compared it to established CAV risk factors.
Results: In the overall population, donor age correlated with mIT (p < 0.001), while in the pediatric subpopulation, both donor age and D-R correlated with mIT (p < 0.001 and p = 0.002, respectively). In the overall population, donor age was a main predictor of higher mIT and CAV IH (p = 0.001 and p = 0.01, respectively) in addition to post-transplant interval, arterial hypertension, and dyslipidemia. In the pediatric patients, dyslipidemia remained a main predictor of both higher mIT and CAV IH (p = 0.004 and p = 0.040, respectively), while donor age and D-R were not.
Conclusion: While there was an effect of the non-modifiable parameter of donor age regarding maximal intimal thickness, a stronger association was seen between the modifiable risk factor dyslipidemia and higher maximal intimal thickness and CAV IH in both the overall population and the pediatric subpopulation.
(© 2024. The Author(s).)
Databáze: MEDLINE
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