Journal article
Severe primary graft dysfunction in heart transplant recipients using donor hearts after circulatory death: United States experience
The Journal of heart and lung transplantation, v 44(5), pp 760-769
01 May 2025
PMID: 39613119
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE: This study compares the incidence of severe Primary Graft Dysfunction (PGD) in a contemporaneous cohort of donors after circulatory death (DCD) and brain death (DBD) heart transplant recipients. METHOD: The United Network for Organ Sharing database was queried for isolated adult heart transplant recipients from 9/2023 to 6/2024. Heart recipients were stratified based on the organ donation type (DCD vs DBD). DCD heart recipients were further categorized based on the procurement method: time between circulatory death to cross-clamp: <= 30 minutes (Direct Procurement and Preservation, DPP), > 30 minutes (Normothermic Regional Perfusion, NRP). Outcomes of interest included: severe PGD (Left/Bi-Ventricular; LV/BiV) at 24 hours and Severe Graft Dysfunction at 72 hours (patients with severe PGD at 24 hours that remain on mechanical support at 72 hours). RESULTS: A total of 2590 adult heart transplant recipients were identified, of which 17.1% underwent DCD heart transplantation. DCD heart recipients were less likely to be on inotrope (36.7% vs 41.6%, p=0.046) and ECMO (4.1% vs 9.9%, p < 0.001) prior to transplant than DBD heart recipients. DCD heart recipients were more likely than DBD heart recipients to develop severe PGD (LV/BiV) at 24 hours (9.5% vs 5.1%, p < 0.001). The Severe Graft Dysfunction at 72 hours (2.3% vs 2.9%, p=0.67) and 30-day mortality were similar between the 2 groups. Recipients of DCD heart procured with DPP or NRP had similar severe PGD (LV/BiV) at 24 hours (9.4% vs 9.7%, p=0.93). CONCLUSION: Severe PGD at 24 hours is higher among the DCD than DBD heart recipients, but Graft Dysfunction improves by 72 hours.
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Details
- Title
- Severe primary graft dysfunction in heart transplant recipients using donor hearts after circulatory death: United States experience
- Creators
- Peter D. Cho - Drexel UniversitySamuel T. Kim - University of California, Los AngelesHedwig Zappacosta - University of California, Los AngelesJohn P. White - University of California, Los AngelesStephanie Mckay - University of California, Los AngelesReshma Biniwale - University of California, Los AngelesAbbas Ardehali (Corresponding Author) - University of California, Los Angeles
- Publication Details
- The Journal of heart and lung transplantation, v 44(5), pp 760-769
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- Sam Malik Foundation
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001471172800001
- Scopus ID
- 2-s2.0-85211704013
- Other Identifier
- 991022197434504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery
- Transplantation