Abstract
Patient and donor risk factors for post-heart transplant mortality have been identified, but the relevance of the procurement procedure itself has not been examined. We sought to assess the impact of donor multiorgan procurement on survival following orthotopic heart transplantation (OHT). From the UNOS STAR database, we included all adult (≥18Y) heart transplants (HT) performed since 2000 and used donor IDs to determine how many other organs were procured from the same donor as the recipient's heart allograft (regardless of recipient). Kaplan-Meier survival functions and risk-adjusted Cox proportional hazards regression models were computed to assess the association of multiorgan procurement with post-heart transplantation mortality. We included 40,336 HT patients. Including the heart, the median number of donor organs procured was 3 (IQR, 3-4). Heart donors underwent liver procurement in 89.7%; kidney(s) in 92.5% (single 95%, bilateral 5%); lung(s) in 38.0% (single 28%, bilateral 72%); pancreas in 10.4%; and intestine in 1.6%. Only 4.5% were multiorgan transplants (i.e., to the same recipient as the heart) - heart/kidney in 1,561 patients and heart/liver in 276. Following risk adjustment across 16 recipient and donor variables, an increasing number of organs procured was independently associated with reduced post-HT mortality (HR 0.92, 95% CI 0.95-0.99, p=0.008). Lung procurement was independently associated with reduced post-HT mortality (HR 0.96, 0.92-0.99, p=0.04), but not liver, kidney, pancreas, or intestine procurement. The protective association with lung procurement appeared to be driven by bilateral (HR 0.94, 0.88-1.01, p=0.07) versus single lung procurement. An increasing number of organs procured from a donor is independently associated with improved survival after heart transplantation. Lung procurement demonstrated a significant protective association. These results may reflect that healthier donors are more likely to be multiorgan donors.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
