Ideal Body Weight Ratio for Donor-to-Recipient Size Matching in Heart Transplantation.
Publication/Presentation Date
11-1-2025
Abstract
BACKGROUND: While various models are useful for donor-recipient size matching, the optimal approach for predicting the correct match remains unclear. We sought to determine the association between ideal body weight (IBW) ratio and post-transplant survival.
METHODS: The United Network for Organ Sharing (UNOS) database was queried for all patients who underwent isolated heart transplantation between July 2000 and July 2023. Donor-recipient size matching was assessed using predicted heart mass (PHM), ideal predicted heart mass (IPHM), and IBW. Ratios were stratified as undersized (≤0.8), properly sized (>0.8 to < 1.2), and oversized (≥1.2). Stratified Kaplan-Meier analysis was conducted using the log-rank test. Restricted cubic splines (RCS) were constructed to evaluate the association with mortality.
RESULTS: A total of 46 721 donor-recipient matches were identified. PHM demonstrated higher survival for properly sized and oversized patients compared to undersized (p < 0.01). For IPHM, survival was highest in the properly sized patients, lower in the oversized, and lowest in the undersized patients (p < 0.01). For IBW, survival was superior in properly sized group compared to undersized and oversized patients (p < 0.03). Non-linear analysis of PHM showed increased mortality risk with undersizing and decreased risk with oversizing (p < 0.01). IPHM demonstrated higher mortality risk with undersizing but no notable risk with oversizing (p < 0.01), whereas IBW showed increased risk with both undersizing and oversizing (p < 0.01).
CONCLUSION: The IBW model appears to be non-inferior to PHM. IBW penalized equally for both undersizing and oversizing, making it potentially an additional useful metric in the evaluation of donor-recipient size matching.
Volume
39
Issue
11
First Page
70369
Last Page
70369
ISSN
1399-0012
Published In/Presented At
Pritting, C. D., Nasher, N., Rahimov, D., Sanders, V., Rame, J. E., Alvarez, R. J., Bavaria, J. E., Entwistle, J. W., Rajagopal, K., Hoopes, C. W., & Tchantchaleishvili, V. (2025). Ideal Body Weight Ratio for Donor-to-Recipient Size Matching in Heart Transplantation. Clinical transplantation, 39(11), e70369. https://doi.org/10.1111/ctr.70369
Disciplines
Medicine and Health Sciences
PubMedID
41137649
Department(s)
Department of Surgery
Document Type
Article