Posttransplantation hemodynamics and exercise function are not affected by body-size matching of donor and recipient.
Because the number of heart transplantations performed is limited by the number of available donor hearts, many centers have expanded the acceptable criteria for donor hearts in an attempt to provide a sufficient number of donors for the number of patients awaiting heart transplantation. Traditionally, body-size matching has been an important criteria for matching donors with potential heart transplant recipients. Although initially thought to be detrimental, studies have shown no difference in survival of patients who receive hearts from smaller donors, but heart performance in this subset of patients who receive undersized hearts has not been extensively examined. We assessed exercise capacity and 1-year posttransplantation hemodynamics in 72 consecutive adult orthotopic heart transplant recipients, grouped according to donor-recipient weight ratio and the ratio of donor to recipient body surface area. Total exercise time and relative oxygen consumption were not significantly different among three groups of patients grouped according to donor-recipient body weight ratio as follows: low, 0.60 to 0.79; mid, 0.80 to 1.0; high, more than 1.0. No difference was noted among the three donor-recipient weight ratio groups with respect to 1-year posttransplantation hemodynamics. Similarly, 1-year posttransplantation hemodynamics were not different between patients with a body surface area ratio of less than 1.0 versus those with a body surface area ratio of 1.0 or more. Differences in pretransplantation hemodynamics or graft preservation did not affect our results. Neither donor-recipient weight ratio nor body surface area ratio correlated with any posttransplantation hemodynamic measurement.(ABSTRACT TRUNCATED AT 250 WORDS)
Morley
D
D
Failure and Transplant Center, Hahnemann University, Philadelphia, Pa. 19102-1192.
Boigon
M
M
Fesniak
H
H
Brubaker
P
P
Walter
J
J
Fitzpatrick
J
J
Chojnowski
D
D
Smith
A
A
Alpern
J
J
Brozena
S
S
D000328:Adult; D016280:Atrial Function, Right / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001824:Body Constitution; D001830:Body Surface Area; D001835:Body Weight; D002302:Cardiac Output / Q000502:physiology; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D016027:Heart Transplantation / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology*; D011651:Pulmonary Artery / Q000502:physiology; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D012189:Retrospective Studies; D014019:Tissue Donors; D014655:Vascular Resistance / Q000502:physiology