title: Impact of donor left ventricular hypertrophy on survival after heart transplant.
abstract: Left ventricular hypertrophy (LVH) of the donor heart is believed to increase the risk of allograft failure after transplant. However this effect is not well quantified, with variable findings from single-center studies. The United Network for Organ Sharing database was used to analyze the effect of donor LVH on recipient survival. Three cohorts, selected in accordance with the American Society of Echocardiography guidelines, were examined: recipients of allografts without LVH (<1.1 cm), with mild LVH (1.1-1.3 cm) and with moderate-severe LVH (≥ 1.4 cm). The study group included 2626 patients with follow-up of up to 3.3 years. Mild LVH was present in 38% and moderate-severe LVH in 5.6% of allografts. Predictors of mortality included a number of donor and recipient characteristics, but not LVH. However, a subgroup analysis showed an increased risk of death in recipients of allografts with LVH and donor age >55 years, and in recipients of allografts with LVH and ischemic time ≥ 4 h. In the contemporary era, close to half of all transplanted allografts demonstrate LVH, and survival of these recipients is similar to those without LVH. However, the use of allografts with LVH in association with other high-risk characteristics may result in increased mortality.
authors: UTAH Cardiac Transplant Program, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
authors: O
authors: O
authors: Wever Pinzon
authors: G
authors: G
authors: Stoddard
authors: S G
authors: SG
authors: Drakos
authors: E M
authors: EM
authors: Gilbert
authors: J N
authors: JN
authors: Nativi
authors: D
authors: D
authors: Budge
authors: F
authors: F
authors: Bader
authors: R
authors: R
authors: Alharethi
authors: B
authors: B
authors: Reid
authors: C H
authors: CH
authors: Selzman
authors: M D
authors: MD
authors: Everitt
authors: A G
authors: AG
authors: Kfoury
authors: J
authors: J
authors: Stehlik
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology / Q000401:mortality*; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D007511:Ischemia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D009927:Tissue and Organ Procurement; D014184:Transplantation, Homologous / Q000401:mortality*