317 Impact of Routinely Performed Coronary Angiography in Older Heart Donors on Heart Transplantation Results

Abstract

tients at increased risk for poor outcomes, particularly the development of cardiac allograft vasculopathy (CAV). Smoking is known to cause coronary endothelial cell injury. However, the role of donor smoking history is unclear. The purpose of the current study was to assess the effect of donor smoking on outcomes of heart transplant recipients. Methods and Materials: We assessed 394 patients transplanted from 1994 to 2010 for donor history of smoking. There were 216 patients whose donor had a smoking history and 178 patients whose donor did not smoke. Outcomes were compared between groups: 5-year survival, 5-year freedom from CAV (stenosis 30%), 5-year freedom from non-fatal major adverse cardiac events (NF-MACE: MI, heart failure, stenting, defibrillator, stroke, and new peripheral vascular disease), and 1-year freedom from any-treated rejection. Results: Recipient age, gender, donor age, reason for transplant, CMV mismatch were similar between groups. Patients in the donor smoking group had a significantly lower 5-year freedom from CAV compared to patients in the donor non-smoking group (78% vs. 88%, p 0.014; figure). However, other outcomes were similar, including 5-year survival (77% vs. 76%, p 0.82), freedom from NF-MACE (87% vs. 85%, p 0.62), and 1st-year freedom from any-treated rejection (92% vs. 90%, p 0.53).