Heart transplantation using allografts from older donors: Multicenter study results

Data de publicació: 01/06/2015

Autors de IIS La Fe

Luis Almenar Bonet

Autor
Francisco Miranda Segovia

Autor
Vicente Mirabet Lis

Autor

Autors aliens a IIS La Fe

Roig E
Crespo-Leiro M
Delgado J
Pérez-Villa F
Luís Lambert J
Teresa Blasco M
Muñiz J
rest of the participants of the Spanish Heart Transplantation Registry

Grups d'Investigació

Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí
Regeneración y Trasplante Cardíaco

Leader

Pilar Sepúlveda Sanchis

Abstract

BACKGROUND: The lengthy waiting time for heart transplantation is associated with high mortality. To increase the number of donors, new strategies have emerged, including the use of hearts from donors >= 50 years old. However, this practice remains controversial. The aim of this study was to evaluate outcomes of patients receiving heart transplants from older donors. METHODS: We retrospectively analyzed 2,102 consecutive heart transplants in 8 Spanish hospitals from 1998 to 2010. Acute and overall mortality were compared in patients with grafts from donors >= 50 years old versus grafts from younger donors. RESULTS: There were 1,758 (84%) transplanted grafts from donors < 50 years old (Group I) and 344 (16%) from donors >= 50 years old (Group II). Group I had more male donors than Group 11 (71% vs 57%, p = 0.0001). The incidence of cardiovascular risk factors was higher in older donors. There were no differences in acute mortality or acute rejection episodes between the 2 groups. Global mortality was higher in Group If (rate ratio, 1.40; 95% confidence interval, 1.18-1.67; p = 0.001) than in Group I. After adjusting for donor cause of death, donor smoking history, recipient age, induction therapy, and cyclosporine therapy, the differences lost significance. Group II had a higher incidence of coronary allograft vasculopathy at 5 years (rate ratio, 1.67; 95% confidence interval, 1.22-2.27; p = 0.001). CONCLUSIONS: There were no differences in acute and overall mortality after adjusting for confounding factors. However, there was a midterm increased risk of coronary allograft vasculopathy with the use of older donors. Careful selection of recipients and close monitoring of coronary allograft vasculopathy are warranted in these patients. J Heart Lung Transplant 2015;34:790-796 (C) 2015 International Society for Heart and Lung Transplantation. All rights reserved.

Dades de la publicació

ISSN/ISSNe:: 1053-2498, 1557-3117
Tipus:: Article
Pàgines:: 790-796
DOI:: 10.1016/j.healun.2014.10.006
PubMed:: 25499140
Factor d'Impacte:: 4,181 SCImago ℠
Quartil:: Q1 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Roig E:: Servicio de Cardiologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Almenar L:: Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Crespo-Leiro M:: Servicio de Cardiologia, Hospital Universitario A Coruña, A Coruña, Spain
Segovia J:: Servicio de Cardiología, Clínica Puerta de Hierro, Majadahonda, Madrid, Spain
Mirabet S:: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Delgado J:: Servicio de Cardiologia, Hospital 12 de Octubre, Madrid, Spain
Pérez-Villa F:: Servicio de Cardiologia, Institut Clínic del Torax, Barcelona, Spain
Luís Lambert J:: Servicio de Cardiologia, Hospital Central de Asturias, Spain
Teresa Blasco M:: Servicio de Cardiologia, Hospital Miguel Servet, Zaragoza, Spain
Muñiz J:: Instituto de Ciencias de la Salud, Universidad de A Coruña, A Coruña, Spain