Interaction between donor obesity and prolonged donor ischemic time in heart transplantation.

Publication/Presentation Date

10-1-2022

Abstract

BACKGROUND: The purpose of the study was to determine the impact of donor obesity on outcomes following heart transplantation in the setting of routine (< 4 h) and prolonged (≥4 h) organ ischemic times.

METHODS: Retrospective review of the 2000-2020 United Network for Organ Sharing Database was performed to identify adult heart transplant recipients and donors. Nearest-neighbor propensity score matching by donor obesity was performed separately among routine and prolonged cohorts, with Kaplan-Meier survival estimates used to assess survival at 5 years following transplantation.

RESULTS: A total of 43,304 heart transplant recipients were included in analysis, with 15,925 (36.8 %) receiving obese donor hearts. After propensity-score matching, 30-day mortality and 5-year survival following transplantation were not statistically different between recipients of obese and non-obese donor hearts when organ ischemic times were routine. In the setting of prolonged organ ischemic times, those receiving obese donor hearts experienced lower 30-day mortality (5.1 % vs 6.7 %, p = 0.04) and improved 5-year survival (74.9 % vs 71.2 %, p <  0.01) compared to non-obese donor hearts.

CONCLUSIONS: Recipients of obese donor hearts experienced improved outcomes compared to those receiving non-obese donor hearts when organ ischemic times exceeded 4 h. These findings suggest that the detrimental impact of prolonged organ ischemic time may be attenuated by donor obesity.

Volume

80

Issue

4

First Page

351

Last Page

357

ISSN

1876-4738

Disciplines

Medicine and Health Sciences

PubMedID

35835640

Department(s)

Department of Surgery

Document Type

Article

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