The effect of donor alcohol abuse on outcomes following heart transplantation

Newman, Joshua; Liebo, Max; Lowes, Brian D.; Basha, Haseeb Ilias; Peled, Yael; Cendrowski, Emily; Zolty, Ronald; Douglas, Dylan; Um, J.; Heroux, Alain; Raichlin, Eugenia

doi:10.1111/ctr.13461

Cited by 3 publications

(1 citation statement)

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“… 16 Recent publications support this and none show a difference in outcome with chronic alcohol use. 12 , 13 , 28 The current study also supports the safety of such donors and should alleviate concerns about using hearts from donors with a history of significant alcohol use.…”

Section: Discussionsupporting

confidence: 65%

Intoxicated Donors and Heart Transplant Outcomes: Long-Term Safety

Baran

Lansinger

Long

et al. 2021

Circ: Heart Failure

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Background: The opioid crisis has led to an increase in available donor hearts, although questions remain about the long-term outcomes associated with the use of these organs. Prior studies have relied on historical information without examining the toxicology results at the time of organ offer. The objectives of this study were to examine the long-term survival of heart transplants in the recent era, stratified by results of toxicological testing at the time of organ offer as well as comparing the toxicology at the time of donation with variables based on reported history. Methods: The United Network for Organ Sharing database was requested as well as the donor toxicology field. Between 2007 and 2017, 23 748 adult heart transplants were performed. United Network for Organ Sharing historical variables formed a United Network for Organ Sharing Toxicology Score and the measured toxicology results formed a Measured Toxicology Score. Survival was examined by the United Network for Organ Sharing Toxicology Score and Measured Toxicology Score, as well as Cox proportional hazards models incorporating a variety of risk factors. Results: The number and percent of donors with drug use has significantly increased over the study period ( P <0.0001). Cox proportional hazards modeling of survival including toxicological and historical data did not demonstrate differences in post-transplant mortality. Combinations of drugs identified by toxicology were not associated with differences in survival. Lower donor age and ischemic time were significantly positively associated with survival ( P <0.0001). Conclusions: Among donors accepted for transplantation, neither history nor toxicological evidence of drug use was associated with significant differences in survival. Increasing use of such donors may help alleviate the chronic donor shortage.

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