Abstract
Purpose The transplantation of hearts from traumatically brain-injured (TBI) donors has been associated with inferior long-term survival. The purpose of this study was to explore the outcomes of heart transplantation using TBI donors in a large national registry. Methods We performed a retrospective cohort analysis of the OPTN/UNOS registry encompassing years 1987 to 2018 for adult candidates (>18 years) waitlisted for isolated heart transplantation. Recipients were stratified into two groups, TBI and non-TBI donors. Propensity score matching was performed across key baseline demographic variables and a 1:1 match was done. Kaplan-Meier analysis was used to estimate survival post-transplant. Cox Proportional Hazards modeling was performed to identify independent predictors of survival. Results A total of 58,474 candidates met inclusion criteria. TBI was the leading cause of death in the donor population. Non-TBI donors (N=27,483) were more likely female (41.6% vs 18.8%, p Conclusion In the largest analysis of heart transplants and their survival according to the type of donor injury: TBI vs non-TBI, we found similar survival in heart transplant recipients. These findings should relieve concerns regarding using this unique donor population in heart transplantation.
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