title: Donor predictors of allograft use and recipient outcomes after heart transplantation.
abstract: BACKGROUND
  Despite a national organ-donor shortage and a growing population of patients with end-stage heart disease, the acceptance rate of donor hearts for transplantation is low. We sought to identify donor predictors of allograft nonuse, and to determine whether these predictors are in fact associated with adverse recipient post-transplant outcomes.
  
  
  RESULTS
  We studied a cohort of 1872 potential organ donors managed by the California Transplant Donor Network from 2001 to 2008. Forty-five percent of available allografts were accepted for heart transplantation. Donor predictors of allograft nonuse included age >50 years, female sex, death attributable to cerebrovascular accident, hypertension, diabetes mellitus, a positive troponin assay, left-ventricular dysfunction and regional wall motion abnormalities, and left-ventricular hypertrophy. For hearts that were transplanted, only donor cause of death was associated with prolonged recipient hospitalization post-transplant, and only donor diabetes mellitus was predictive of increased recipient mortality.
  
  
  CONCLUSIONS
  Whereas there are many donor predictors of allograft discard in the current era, these characteristics seem to have little effect on recipient outcomes when the hearts are transplanted. Our results suggest that more liberal use of cardiac allografts with relative contraindications may be warranted.
authors: Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. kiran@stanford.edu
authors: Kiran K
authors: KK
authors: Khush
authors: Rebecca
authors: R
authors: Menza
authors: John
authors: J
authors: Nguyen
authors: Jonathan G
authors: JG
authors: Zaroff
authors: Benjamin A
authors: BA
authors: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California; D046148:Donor Selection; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D055815:Young Adult
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