title: Heart transplant outcomes in recipients of Centers for Disease Control (CDC) high risk donors.
abstract: BACKGROUND
  A lack of donor hearts remains a major limitation of heart transplantation. Hearts from Centers for Disease Control (CDC) high-risk donors can be utilized with specific recipient consent. However, outcomes of heart transplantation with CDC high-risk donors are not well known. We sought to define outcomes, including posttransplant hepatitis and human immunodeficiency virus (HIV) status, in recipients of CDC high-risk donor hearts at our institution.
  
  
  METHODS
  All heart transplant recipients from August 2010 to December 2014 (n = 74) were reviewed. Comparison of 1) CDC high-risk donor (HRD) versus 2) standard-risk donor (SRD) groups were performed using chi-squared tests for nominal data and Wilcoxon two-sample tests for continuous variables. Survival was estimated with Kaplan-Meier curves.
  
  
  RESULTS
  Of 74 heart transplant recipients reviewed, 66 (89%) received a SRD heart and eight (11%) received a CDC HRD heart. We found no significant differences in recipient age, sex, waiting list 1A status, pretransplant left ventricular assist device (LVAD) support, cytomegalovirus (CMV) status, and graft ischemia times (p = NS) between the HRD and SRD groups. All of the eight HRD were seronegative at the time of transplant. Postoperatively, there was no significant difference in rejection rates at six and 12 months posttransplant. Importantly, no HRD recipients acquired hepatitis or HIV. Survival in HRD versus SRD recipients was not significantly different by Kaplan-Meier analysis (log rank p = 0.644) at five years posttransplant.
  
  
  CONCLUSIONS
  Heart transplants that were seronegative at the time of transplant had similar posttransplant graft function, rejection rates, and five-year posttransplant survival versus recipients of SRD hearts. At our institution, no cases of hepatitis or HIV occurred in HRD recipients in early follow-up.
authors: Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors: Athanasios
authors: A
authors: Tsiouris
authors: Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors: Lynn
authors: L
authors: Wilson
authors: Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors: Rajesh B
authors: RB
authors: Sekar
authors: Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors: Abeel A
authors: AA
authors: Mangi
authors: Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors: James J
authors: JJ
authors: Yun
mesh_terms: D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D016009:Chi-Square Distribution; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D016027:Heart Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D006505:Hepatitis / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012306:Risk; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D015996:Survival Rate; D014019:Tissue Donors / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D066027:Transplant Recipients / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult