Use of heavy drinking donors in heart transplantation is not associated with worse mortality

Sharven Taghavi, Senthil N. Jayarajan, Eugene Komaroff, Akira Shiose, Daniel Schwartz, Eman Hamad, Rene Alvarez, Grayson Wheatley, T. Sloane Guy, Yoshiya Toyoda

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background. Although orthotopic heart transplantation (OHT) remains the preferred treatment for end-stage heart failure, there continues to be a critical shortage of organ donors. The goal of this study is to examine outcomes after orthotopic OHT using heavy drinking donors (HDDs) in a large, national database. Methods. The United Network for Organ Sharing database was examined for all primary, adult OHT carried out from 2005 to 2012. Results. There were 14,928 total OHT performed during the study period with 2,274 (15.2%) using HDD. Recipients of HDD were older (53.4 vs. 51.9 years, P < 0.001), more likely men (80.7 vs 74.4%, P < 0.001), less likely sex mismatched (21.5 vs 27.5%, P < 0.001), more likely race mismatched (57.4 vs 52.4%, P < 0.001), and had less total HLA mismatches (4.55 vs 4.65, P < 0.001). The HDD were older (37.0 vs 30.5 years, P < 0.001), more likely men (82.2 vs 69.9%, P < 0.001), and more likely to have heavy cigarette use (38.1 vs 13.2%, P < 0.001). Length of stay was not different (20.3 vs 19.7 days, P = 0.02). On multivariate analysis, use of HDD was not associated with mortality at 30 days (hazards ratio [HR], 1.12; 95% confidence interval [95% CI], 0.90-1.39; P = 0.30), 1 year (HR, 0.96; 95% CI, 0.83-1.11; P = 0.56), and at 5 years (HR, 1.02; 95% CI, 0.91-1.13; P = 0.79). Variables associated with mortality at 5 years included increasing donor age, prolonged ischemic time, worsening recipient creatinine, recipient black race, sex mismatch, and extracorporeal membrane oxygenation or mechanical ventilation as a bridge to transplantation. Conclusion. Heart transplantation can be performed using carefully selected HDDs with good outcomes.

Original languageEnglish
Pages (from-to)1226-1230
Number of pages5
JournalTransplantation
Volume99
Issue number6
DOIs
Publication statusPublished - Jun 6 2015
Externally publishedYes

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Heart Transplantation
Drinking
Tissue Donors
Mortality
Confidence Intervals
Databases
Extracorporeal Membrane Oxygenation
Artificial Respiration
Tobacco Products
Length of Stay
Creatinine
Multivariate Analysis
Heart Failure
Transplantation

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Taghavi, S., Jayarajan, S. N., Komaroff, E., Shiose, A., Schwartz, D., Hamad, E., ... Toyoda, Y. (2015). Use of heavy drinking donors in heart transplantation is not associated with worse mortality. Transplantation, 99(6), 1226-1230. https://doi.org/10.1097/TP.0000000000000514

Use of heavy drinking donors in heart transplantation is not associated with worse mortality. / Taghavi, Sharven; Jayarajan, Senthil N.; Komaroff, Eugene; Shiose, Akira; Schwartz, Daniel; Hamad, Eman; Alvarez, Rene; Wheatley, Grayson; Guy, T. Sloane; Toyoda, Yoshiya.

In: Transplantation, Vol. 99, No. 6, 06.06.2015, p. 1226-1230.

Research output: Contribution to journalArticle

Taghavi, S, Jayarajan, SN, Komaroff, E, Shiose, A, Schwartz, D, Hamad, E, Alvarez, R, Wheatley, G, Guy, TS & Toyoda, Y 2015, 'Use of heavy drinking donors in heart transplantation is not associated with worse mortality', Transplantation, vol. 99, no. 6, pp. 1226-1230. https://doi.org/10.1097/TP.0000000000000514
Taghavi, Sharven ; Jayarajan, Senthil N. ; Komaroff, Eugene ; Shiose, Akira ; Schwartz, Daniel ; Hamad, Eman ; Alvarez, Rene ; Wheatley, Grayson ; Guy, T. Sloane ; Toyoda, Yoshiya. / Use of heavy drinking donors in heart transplantation is not associated with worse mortality. In: Transplantation. 2015 ; Vol. 99, No. 6. pp. 1226-1230.
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title = "Use of heavy drinking donors in heart transplantation is not associated with worse mortality",
abstract = "Background. Although orthotopic heart transplantation (OHT) remains the preferred treatment for end-stage heart failure, there continues to be a critical shortage of organ donors. The goal of this study is to examine outcomes after orthotopic OHT using heavy drinking donors (HDDs) in a large, national database. Methods. The United Network for Organ Sharing database was examined for all primary, adult OHT carried out from 2005 to 2012. Results. There were 14,928 total OHT performed during the study period with 2,274 (15.2{\%}) using HDD. Recipients of HDD were older (53.4 vs. 51.9 years, P < 0.001), more likely men (80.7 vs 74.4{\%}, P < 0.001), less likely sex mismatched (21.5 vs 27.5{\%}, P < 0.001), more likely race mismatched (57.4 vs 52.4{\%}, P < 0.001), and had less total HLA mismatches (4.55 vs 4.65, P < 0.001). The HDD were older (37.0 vs 30.5 years, P < 0.001), more likely men (82.2 vs 69.9{\%}, P < 0.001), and more likely to have heavy cigarette use (38.1 vs 13.2{\%}, P < 0.001). Length of stay was not different (20.3 vs 19.7 days, P = 0.02). On multivariate analysis, use of HDD was not associated with mortality at 30 days (hazards ratio [HR], 1.12; 95{\%} confidence interval [95{\%} CI], 0.90-1.39; P = 0.30), 1 year (HR, 0.96; 95{\%} CI, 0.83-1.11; P = 0.56), and at 5 years (HR, 1.02; 95{\%} CI, 0.91-1.13; P = 0.79). Variables associated with mortality at 5 years included increasing donor age, prolonged ischemic time, worsening recipient creatinine, recipient black race, sex mismatch, and extracorporeal membrane oxygenation or mechanical ventilation as a bridge to transplantation. Conclusion. Heart transplantation can be performed using carefully selected HDDs with good outcomes.",
author = "Sharven Taghavi and Jayarajan, {Senthil N.} and Eugene Komaroff and Akira Shiose and Daniel Schwartz and Eman Hamad and Rene Alvarez and Grayson Wheatley and Guy, {T. Sloane} and Yoshiya Toyoda",
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T1 - Use of heavy drinking donors in heart transplantation is not associated with worse mortality

AU - Taghavi, Sharven

AU - Jayarajan, Senthil N.

AU - Komaroff, Eugene

AU - Shiose, Akira

AU - Schwartz, Daniel

AU - Hamad, Eman

AU - Alvarez, Rene

AU - Wheatley, Grayson

AU - Guy, T. Sloane

AU - Toyoda, Yoshiya

PY - 2015/6/6

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N2 - Background. Although orthotopic heart transplantation (OHT) remains the preferred treatment for end-stage heart failure, there continues to be a critical shortage of organ donors. The goal of this study is to examine outcomes after orthotopic OHT using heavy drinking donors (HDDs) in a large, national database. Methods. The United Network for Organ Sharing database was examined for all primary, adult OHT carried out from 2005 to 2012. Results. There were 14,928 total OHT performed during the study period with 2,274 (15.2%) using HDD. Recipients of HDD were older (53.4 vs. 51.9 years, P < 0.001), more likely men (80.7 vs 74.4%, P < 0.001), less likely sex mismatched (21.5 vs 27.5%, P < 0.001), more likely race mismatched (57.4 vs 52.4%, P < 0.001), and had less total HLA mismatches (4.55 vs 4.65, P < 0.001). The HDD were older (37.0 vs 30.5 years, P < 0.001), more likely men (82.2 vs 69.9%, P < 0.001), and more likely to have heavy cigarette use (38.1 vs 13.2%, P < 0.001). Length of stay was not different (20.3 vs 19.7 days, P = 0.02). On multivariate analysis, use of HDD was not associated with mortality at 30 days (hazards ratio [HR], 1.12; 95% confidence interval [95% CI], 0.90-1.39; P = 0.30), 1 year (HR, 0.96; 95% CI, 0.83-1.11; P = 0.56), and at 5 years (HR, 1.02; 95% CI, 0.91-1.13; P = 0.79). Variables associated with mortality at 5 years included increasing donor age, prolonged ischemic time, worsening recipient creatinine, recipient black race, sex mismatch, and extracorporeal membrane oxygenation or mechanical ventilation as a bridge to transplantation. Conclusion. Heart transplantation can be performed using carefully selected HDDs with good outcomes.

AB - Background. Although orthotopic heart transplantation (OHT) remains the preferred treatment for end-stage heart failure, there continues to be a critical shortage of organ donors. The goal of this study is to examine outcomes after orthotopic OHT using heavy drinking donors (HDDs) in a large, national database. Methods. The United Network for Organ Sharing database was examined for all primary, adult OHT carried out from 2005 to 2012. Results. There were 14,928 total OHT performed during the study period with 2,274 (15.2%) using HDD. Recipients of HDD were older (53.4 vs. 51.9 years, P < 0.001), more likely men (80.7 vs 74.4%, P < 0.001), less likely sex mismatched (21.5 vs 27.5%, P < 0.001), more likely race mismatched (57.4 vs 52.4%, P < 0.001), and had less total HLA mismatches (4.55 vs 4.65, P < 0.001). The HDD were older (37.0 vs 30.5 years, P < 0.001), more likely men (82.2 vs 69.9%, P < 0.001), and more likely to have heavy cigarette use (38.1 vs 13.2%, P < 0.001). Length of stay was not different (20.3 vs 19.7 days, P = 0.02). On multivariate analysis, use of HDD was not associated with mortality at 30 days (hazards ratio [HR], 1.12; 95% confidence interval [95% CI], 0.90-1.39; P = 0.30), 1 year (HR, 0.96; 95% CI, 0.83-1.11; P = 0.56), and at 5 years (HR, 1.02; 95% CI, 0.91-1.13; P = 0.79). Variables associated with mortality at 5 years included increasing donor age, prolonged ischemic time, worsening recipient creatinine, recipient black race, sex mismatch, and extracorporeal membrane oxygenation or mechanical ventilation as a bridge to transplantation. Conclusion. Heart transplantation can be performed using carefully selected HDDs with good outcomes.

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