Abstract
Incidence of Severe PGD Following DCD Heart Transplantation Using NRP vs. DPP
The Journal of heart and lung transplantation, v 45(5), pp 307-307
Apr 2026
Abstract
Purpose: Severe primary graft dysfunction (PGD) is a leading cause of early mortality after heart transplantation. As donation after circulatory death (DCD) expands, the effect of procurement —normothermic regional perfusion (NRP) vs. direct procurement and perfusion (DPP)—on severe PGD risk remains unclear. This study evaluates severe PGD among DCD heart recipients by technique.
Methods: The UNOS database was queried for adult isolated DCD heart transplants (Sep 2023-Jun 2025). Severe PGD was defined per 2014 ISHLT criteria as left or biventricular dysfunction within 24 hours requiring mechanical circulatory support. The primary outcome was severe PGD at 24 hours; secondary outcomes included PGD at 72 hours and hospital stay. Logistic regression with LASSO refinement identified predictors of severe PGD.
Results: Among 1,164 DCD heart recipients, 426 (36.6%) underwent NRP. NRP donors were older (35 vs. 33 years, p<0.001) and had higher creatinine (1.33 vs. 1.12 mg/dL, p=0.022). Severe PGD at 24 hours (9.4% vs. 11.0%, p=0.43) and 72 hours (4.7% vs. 5.6%, p=0.53) were similar. Hospital stay was slightly shorter with NRP (16 vs. 17 days, p=0.036). Procurement method was not associated with PGD (OR 1.03, 95% CI 0.65-1.63, p=0.91). Temporal analysis (Figure 1) showed no significant differences in PGD rates between NRP and DPP, though variability suggests possible evolving trends as NRP utilization increased.
Conclusion: NRP and DPP yield comparable rates of severe PGD after DCD heart transplantation, supporting NRP as a safe, effective approach to expand the donor pool without increasing early graft dysfunction risk.
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Details
- Title
- Incidence of Severe PGD Following DCD Heart Transplantation Using NRP vs. DPP
- Creators
- J. Song - University of California, Los AngelesP. Cho - Drexel UniversityM. Daniel - University of California, Los AngelesS. McKay - University of California, Los AngelesH. Zappacosta - University of California, Los AngelesJ. White - University of California, Los AngelesA. Abramov - University of California, Los AngelesM. Husain - University of California, Los AngelesA. Ardehali - University of California, Los Angeles
- Publication Details
- The Journal of heart and lung transplantation, v 45(5), pp 307-307
- Conference
- 46th Annual Meeting and Scientific Sessions of the International Society for Heart and Lung Transplantation (ISHLT), 46th (Toronto, Ontario, Canada, 22 Apr 2026–26 Apr 2026)
- Publisher
- Elsevier
- Number of pages
- 1
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001761994900107
- Other Identifier
- 991022189367604721