Individual Association of Predicted Left and Right Ventricular Mass Ratios With Survival After Heart Transplantation: A UNOS Database Analysis.
Publication/Presentation Date
2-1-2025
Abstract
BACKGROUND: Predicted heart mass (PHM) ratio is a commonly used metric for donor-to-recipient size matching that has been associated with survival after heart transplantation (HTx). PHM represents a sum of two separate statistical models for predicted left ventricular mass (PLVM) and predicted right ventricular mass (PRVM); however, their individual contributions have not been sufficiently studied. We sought to assess the association of donor-to-recipient PLVM (PLVMR) and PRVM ratios (PRVMR) with overall posttransplant survival individually.
METHODS: Adult heart transplant recipients from 2005 to 2021 were queried from the UNOS database. A three-dimensional tensor product spline model assessed the association of PLVMR and PRVMR with survival simultaneously on a continuous distribution. Subsequently, PLVMR and PRVMR were explored individually using individual restricted cubic spline models.
RESULTS: A total of 25 549 patients were analyzed. Of these, female recipients comprised 26.7% (n = 6818), and the median age was 56 [IQR 46-63] years. In the three-dimensional restricted cubic spline (3D-RCS) model, PLVMR and PRVMR were significantly associated with survival (p value: overall = 0.002, PLVMR = 0.0006, PRVMR = 0.0006, PLVMR*PRVMR = 0.0002). When analyzed with two-dimensional restricted cubic spline (2D-RCS) models, PLVMR was not associated with survival (p = 0.59), while PRVMR retained its significant association (p = 0.04).
CONCLUSION: While both PLVMR and PRVMR appear to be associated with posttransplant survival, the effect of PRVMR might be disproportionately high as PRVM makes up a much smaller fraction of PHM than PLVM.
Volume
39
Issue
2
First Page
70113
Last Page
70113
ISSN
1399-0012
Published In/Presented At
Jain, A., Pritting, C., Brodie, A., Rahimov, D., Ahmad, D., Rame, J. E., Alvarez, R., Rajagopal, K., Entwistle, J. W., & Tchantchaleishvili, V. (2025). Individual Association of Predicted Left and Right Ventricular Mass Ratios With Survival After Heart Transplantation: A UNOS Database Analysis. Clinical transplantation, 39(2), e70113. https://doi.org/10.1111/ctr.70113
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
39964044
Department(s)
Administration and Leadership
Document Type
Article