Donor and recipient risk factor analysis of inferior postheart transplantation outcome in the era of durable mechanical assist devices

Marian Urban, Karen Booth, Stephan Schueler, Ivan Netuka, Guy MacGowan

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

The study objective is to quantify the impact of donor and recipient variables on heart transplant survival in recipients with a significant proportion of implanted continuous-flow left ventricular assist devices (LVADs). This is a prospective cohort study of International Society for Heart and Lung Transplantation (ISHLT) Registry that includes all primary heart-alone transplants in adult recipients (January 2005 and June 2013, N = 15 532, 27% LVADs). Donor and recipient characteristics were assessed for association with death or graft failure within 90 days and between 90 days and 5 years after transplantation. On Cox proportional hazard model donor cause of death other than head trauma (hazard ratio [HR] 1.985, P < 0.0001), recipient congenital (HR 2.7555, P < 0.0001) and ischemic (HR 1.165, P = 0.0383) vs dilated etiology and female donor heart transplanted into male recipient (HR 1.207, P = 0.0354) were predictors of death or graft failure within 90 days. Between 90 days and 5 years, donor cigarette use (HR 1.232, P = 0.0001), recipient cigarette use (HR 1.193, P = 0.0003), diabetes (HR 1.159, P = 0.0050), arterial hypertension (HR 1.129, P = 0.0115), and ischemic vs dilative cardiomyopathy had an increased probability of death or graft failure.

Original languageEnglish (US)
Article numbere13390
JournalClinical Transplantation
Volume32
Issue number10
DOIs
StatePublished - Oct 2018

Keywords

  • donor characteristics
  • donor-recipient matching
  • heart transplantation
  • left ventricular assist device
  • mechanical assist device
  • recipient characteristics

ASJC Scopus subject areas

  • Transplantation

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