May 30, 2020

Comparing Mortality in Heart Transplantation Utilizing Donor Hearts with and without CAD

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
R R ChandE C DePasquale

Abstract

We want to determine if there is a difference in outcomes in heart transplant (HTx) recipients who receive donor hearts with known coronary artery disease (CAD) versus those without CAD. Using the United Network of Organ Sharing (UNOS) Organ Registry, we compared mortality rates for HTx recipients who received donor hearts without CAD versus those with CAD with a multivariate Cox proportional hazard regression model adjusting for age, sex, race, diabetes diagnosis, ischemic time, need for dialysis/life support, recipient wait-time, and HLA mismatch. CAD was defined as 1 or more epicardial coronary vessels with ≥ 50% stenosis. We excluded patients who were age <10, lost-to-follow-up, multi-organ transplant and redo transplant recipients. We censored data at 10 years. There were a total of 45,236 unknown-CAD HTx recipients, 650 non-CAD HTx recipients and 79 CAD HTx recipients in the UNOS Organ Registry. Non-CAD HTx recipients were less likely to have had prior cardiac surgery (61.2% vs 77.2% respectively, p=0.005), more likely to receive a younger donor heart (45.0±8.4 years vs 48.0±6.9 years respectively, p=0.002), less likely to have a VAD at time of transplant (59.4% vs 78.5% respectively, p<0.001), and more likely to be liste...Continue Reading

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Mentioned in this Paper

Racial Group
Multifactorial
Heart Transplantation
Organ Transplantation
Cox Proportional Hazards Models
Donor: Type: Point in Time: ^Patient: Nominal
Transplantation
Diabetes
Coronary Arteriosclerosis
WISKOTT-ALDRICH SYNDROME, SOMATIC, 1A-T

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