title: Use of cardiac allografts with mild and moderate left ventricular hypertrophy can be safely used in heart transplantation to expand the donor pool.
abstract: OBJECTIVE
  The purpose of this study was to evaluate outcomes of heart transplantation (HTx) and changes in left ventricular wall thickness (LVWT) post-HTx using donors with left ventricular hypertrophy (LVH).
  
  
  BACKGROUND
  Limited data are available on use of donor hearts with LVH in HTx.
  
  
  METHODS
  We reviewed 427 patients who underwent HTx: 62 received hearts with LVH (interventricular septum [IVS] or posterior wall [PW] thickness >or=1.2 cm) by echocardiography, and 365 received hearts without LVH. The median follow-up was 3.8 years (range 0 to 16.2 years).
  
  
  RESULTS
  Recipient age was 56 +/- 11 years and donor age was 30 +/- 12 years. Baseline recipient characteristics were similar in both groups. Donors with LVH were older (35 +/- 12 years vs. 29 +/- 12 years, p = 0.001) and had higher rates of intracranial hemorrhage (38% vs. 15%, p = 0.001). The LVWT was increased in the LVH group compared with LVWT in the non-LVH group (IVS: 1.28 +/- 0.18 cm vs. 0.85 +/- 0.19 cm, PW: 1.27 +/- 0.19 cm vs. 0.85 +/- 0.20 cm, p = 0.0001 for both groups). Mild LVH (1.2 to 1.3 cm) was found in 42%, moderate (>1.3 to 1.7 cm) in 53%, and severe (>1.7 cm) in 5% of donors with LVH. Left ventricular wall thickness regression occurred in both IVS and PW (1.28 +/- 0.18 cm vs. 1.10 +/- 0.13 cm vs. 1.13 +/- 0.14 cm, and 1.27 +/- 0.19 cm vs. 1.11 +/- 0.11 cm vs. 1.13 +/- 0.14 cm, at baseline, 1 year, and 5 years, respectively; p < 0.001 for change from baseline to 1 and 5 years for both locations). Patients with or without donor LVH had similar 1-year (3.5% vs. 9.5%, p = 0.2) and 5-year survival rates (84 +/- 5.9% vs. 70 +/- 2.7%, p = 0.07).
  
  
  CONCLUSIONS
  Short- and long-term survival rates and rates of LVH at follow-up were similar in both groups, suggesting that donor hearts with mild and moderate LVH can be safely used in HTx.
authors: Division of Cardiology, Kaplan Medical Center, Rehovot, Israel.
authors: Sorel
authors: S
authors: Goland
authors: Lawrence S C
authors: LS
authors: Czer
authors: Robert M
authors: RM
authors: Kass
authors: Robert J
authors: RJ
authors: Siegel
authors: James
authors: J
authors: Mirocha
authors: Michele A
authors: MA
authors: De Robertis
authors: Jason
authors: J
authors: Lee
authors: Sharo
authors: S
authors: Raissi
authors: Wen
authors: W
authors: Cheng
authors: Gregory
authors: G
authors: Fontana
authors: Alfredo
authors: A
authors: Trento
mesh_terms: D000293:Adolescent; D000328:Adult; D004452:Echocardiography; D005260:Female; D016027:Heart Transplantation; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014184:Transplantation, Homologous; D016896:Treatment Outcome