Changing donor and recipient demographics in a heart transplantation program: influence on early outcome

Solomon, Neville; Mcgiven, James; Alison, Peter; Ruygrok, Peter; Haydock, David; Coverdale, H. A.; West, Teena

doi:10.1016/j.athoracsur.2003.09.086

Cited by 39 publications

(23 citation statements)

References 26 publications

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“…Older donors have a greater risk of pre-existing heart disease, especially atherosclerosis [9,10], and this may explain the worse outcomes in some studies [1,11]. However, carefully selected hearts from donors aged above 50 years achieve equivalent outcomes [12,13]. Coronary angiography for donor selection with extended age criteria [10] remains difficult in the UK and many other countries because all hospitals do not have ready 24-h access to angiography.…”

Section: Discussionmentioning

confidence: 99%

Trends in adult heart transplantation: a national survey from the United Kingdom Cardiothoracic Transplant Audit 1995–2007☆☆☆

Thekkudan

Rogers

Thomas

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Trends in adult heart transplantation: a national survey from the United Kingdom Cardiothoracic Transplant Audit 1995–2007☆☆☆

Thekkudan

Rogers

Thomas

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…12 In another study in which mortality was not significantly higher with female donor hearts, female donor gender was a risk factor for lower cardiac output and more frequent intraaortic balloon pump insertions after heart transplantation. 13 Furthermore, a review of data from > 18 000 heart transplantations from multiple centers showed that female recipients, irrespective of donor gender, had 3.6% lower survival than male recipients 5 years after heart transplantation; males who received organs from male donors had the greatest cumulative survival at 5 years (75%), but males receiving female hearts had a 15% increase in the risk of adjusted cumulative mortality. 3 …”

Section: Discussionmentioning

confidence: 99%

Gender-Based Analysis of Outcome After Heart Transplantation

Eifert

Kofler²,

Nickel³

et al. 2012

Exp Clin Transplant

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Objectives: Gender differences between donors and recipients might have an effect on outcome after heart transplantation. Literature and registries reveal controversial results. We reviewed 1000 heart transplantations at our center focusing on the influence of gender differences on short-and longterm outcome after heart transplantation. Materials and Methods:We performed a retrospective analysis of 1000 (960 primary and 40 redo-heart transplantations) between August 1981 and July 2008. In contrast to other studies, the data for gender differences (donor gender and recipient gender) were evaluated for recipient survival and survival conditional to early mortality. Results: Female donors are significantly older than male donors (females, 36.5 ± 14.5 years; males, 31.2 ± 13.8 years). One-year survival was significantly inferior in male recipients receiving female donor hearts (mR/fD: 73.7%) compared to females receiving male donor organs (fR/mD: 90.9%) (P = .045). Univariate analysis revealed that, for recipients who survived > 1 year, survival at 10 years was significantly greater for female donors and female recipients (90%) than it was for male donors and male recipients (72%; P = .034). Multivariate analysis showed that the gender combination with female donors and female recipients was an independent indicator for greater long-term survival (P = .04). Conclusions: The gender combination of female donors and male recipients had a greater risk for early mortality after heart transplantation, and the combination of male donors and female recipients resulted in favorable short-term outcomes. In longterm follow-up, recipients of hearts from female donors had better survival, especially female recipients.

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“…Several early studies identified female donor sex to be an independent predictor of mortality. [1][2][3][4] Complicating the issue, however, is the fact that unlike other solid organs, Ͼ75% of OHT recipients have traditionally been male. 5 Thus, it may well be the interplay between donor and recipient sex (rather than the sex of the donor or recipient individually) that most influences outcomes.…”

Section: Editorial See P 389 Clinical Perspective On P 408mentioning

confidence: 99%

The Impact of Donor-Recipient Sex Matching on Survival After Orthotopic Heart Transplantation

Weiss

Allen

Patel

et al. 2009

Circ: Heart Failure

139

126

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Introduction— Single-institution series have suggested that men receiving orthotopic heart transplantation from female donors have decreased survival. No multi-institutional series has comprehensively addressed the issue of donor and recipient sex matching for both male and female orthotopic heart transplantation recipients. Methods and Results— We used data from the multi-institutional prospectively collected United Network for Organ Sharing open transplantation cohort to review 18 240 adult patients who received orthotopic heart transplantation from 1999 to 2007. Four donor recipient strata were identified (male donor/male recipient, N=10 750; female donor/female recipient, N=2201; male donor/female recipient, N=2121; and female donor/male recipient, N=3168). The primary end point of all cause posttransplant mortality was compared among groups using a Cox proportional hazard regression model with additional propensity adjustment. Female recipients, irrespective of donor sex, had 3.6% lower overall survival at 5 years posttransplant ( P =0.003). Men who received organs from male donors had the highest cumulative survival at 5 years (74.5%). Men receiving female hearts had a 15% increase in the risk of adjusted cumulative mortality (hazard ratio, 1.15; 95% CI, 1.02 to 1.30; P =0.02). No significant increase in the relative hazard for death occurred for women receiving opposite sex donor organs (1.24; 0.92 to 1.35; P =0.31). Conclusions— The United Network for Organ Sharing data set has provided a large sample examining donor recipient sex pairing in orthotopic heart transplantation. Men receiving organs for same sex donors have significantly improved short- and long-term survival. No survival advantage was seen for women with same sex donors.

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Changing donor and recipient demographics in a heart transplantation program: influence on early outcome

Cited by 39 publications

References 26 publications

Trends in adult heart transplantation: a national survey from the United Kingdom Cardiothoracic Transplant Audit 1995–2007☆☆☆

Trends in adult heart transplantation: a national survey from the United Kingdom Cardiothoracic Transplant Audit 1995–2007☆☆☆

Gender-Based Analysis of Outcome After Heart Transplantation

The Impact of Donor-Recipient Sex Matching on Survival After Orthotopic Heart Transplantation

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