Multiorgan procurement is associated with a survival benefit after heart transplantation.
Publication/Presentation Date
8-1-2020
Abstract
We assessed the impact of donor multiorgan procurement on survival following orthotopic heart transplantation (OHT). From the UNOS STAR database, we included all adult (≥18 Y) heart transplants (OHT) performed since 2000 and used donor IDs to determine how many other organs were procured from the same donor as the recipient's heart allograft (regardless of recipient). The Kaplan-Meier survival functions and risk-adjusted Cox proportional hazards regression models were computed to assess the association of multiorgan procurement with post-heart transplantation mortality. We included 40 336 OHT patients. Including the heart, the median number of donor organs procured was 3 (IQR, 3-4). Heart donors underwent liver procurement in 89.7%; kidney(s) in 98.1% (single 95%, bilateral 5%); lung(s) in 38.0% (single 28%, bilateral 72%); pancreas in 10.4%; and intestine in 1.6%. Following risk adjustment across 16 recipient- and donor-specific variables, an increasing number of organs procured were independently associated with reduced post-OHT mortality (HR 0.98, 95% CI 0.96-0.99, P = .025). Though no significant associations were found examining specific organ types, double lung procurement trended toward a protective effect (HR 0.96, 0.92-1.01, P = .086), with counts of non-lung organs procured still bordering on significance (HR 0.97, 95% CI 0.95-1.00, P = .067). These results likely reflect improved multiorgan donor quality.
Volume
34
Issue
8
First Page
13901
Last Page
13901
ISSN
1399-0012
Published In/Presented At
Magruder, J. T., Suzuki, Y., Sperry, A., Vasquez, C. R., Smood, B., Grimm, J. C., Atluri, P., Bermudez, C., Acker, M. A., Wald, J. W., Cantu, E., & Cevasco, M. (2020). Multiorgan procurement is associated with a survival benefit after heart transplantation. Clinical transplantation, 34(8), e13901. https://doi.org/10.1111/ctr.13901
Disciplines
Medicine and Health Sciences
PubMedID
32400887
Department(s)
Department of Surgery
Document Type
Article