784-4 Older Donor Age Predicts Increased Risk for Coronary Vasculopathy in the Year Following Transplantation: Serial Examination by Intravascular Ultrasound

Abstract

We have previously shown a high prevalence of transmision of atherosclerosis to recipients examined by intravascular ultrasound within a few weeks of transplantation. However, the effect of donor characteristics on progression of vasculopathy is uncertain. We examined 22 patients by intravascular ultrasound within 1.0 ± 0.2 months after transplantation. Identical sites were imaged again at one year follow-up (12 ± 0.5 months) to determine donor-related factors associated with the development of intimal thickening during the first year. Intravascular imaging was performed in multiple coronary arteries (2.2 arteries/patient) using a 3.5 Fr, 30 MHz probe. A core laboratory, blinded to patient identity and to time from transplantation, quantified minimum lumen diameter, plaque cross-sectional area, intimal thickness, and percent area reduction. Donor gender, hypertension and smoking did not predict progression of vasculopathy in the first year. However, older donor age was a strong predictor of measures of disease progression. Donor Group: Increase in Intimal Thickness (mm) Plaque Area (mm2) Area Reduction % Age < 35 0.12 0.63 4.7 Age > 35 028 2.08 10.3 Pvalue <0.008 <0.001 <0.024 Recipients of older donor hearts develop more intimal thickening in the first year following transplantation. Longer follow-up will be required to prove that this increase in intimal thickeness correlates with the subsequent development of severe vasculopathy. These findings have implications for donor organ acceptance criteria.