Abstract 18197: Relationship Between Donor Ejection Fraction and Left Ventricular Wall Thickness With Mortality Among Heart Transplants Recipients

Abstract

Introduction: Limited availability of donor hearts contributes to significant mortality in patients waitlisted for heart transplantation (HTx). Donor hearts with reduced ejection fraction (EF) and left ventricular hypertrophy are considered to adversely affect long term HTX outcomes and are rejected. Objective: To determine the relationship of donor’s EF and left ventricular wall thickness (LVWT) with mortality in HTx recipients. Method: Retrospective analysis from The United Network for Organ Sharing (UNOS) registry. Adult HTx recipients with donor's EF and LVWT recorded from 2006 to 2022 were included. Study sample was grouped into four groups (Group 1 EF>50% & LVWT<1.4cm, group 2 EF≤50% & LVWT<1.4cm, group 3 EF>50% & LVWT≥1.4cm, and group 4 EF≤50% & LVWT≥1.4cm) according to donor characteristics. Primary end point: mortality (30 days, 1 year, and 5 years). Results: 21,012 patients were included, in which 19,205(91.4%) were in group 1, 898(4.3%) in group 2, 867(4.1%) in group 3, and 42(0.2%) in group 4. There were significant differences in baseline characteristics between the groups (Table 1). Unadjusted mortality was 6.3%, 6.0%, 6.0%, and 2.4% (p=0.86) at 30 days; 16.2%, 13.5%, 16.8%, and 7.3% (p=0.08) at 1 year; and 32.2%, 29.2%, 35.4%, and 29.0% (p=0.18) at 5 years, respectively (Table 1 and Figure 1). Neither adjusted mortality was different across the groups (Table 2). Conclusion: There were no significant differences in recipient mortality in different groups based on donor EF and LVWT. Expanding the donor selection criteria would allow for increase in the donor pool and assist in decreasing the mortality, while on the wait list for HTx.