The Effect of Donor-Recipient Heart Mass and Size Matching in Primary Graft Dysfunction Development after Heart Transplantation

Abstract

Purpose To describe the characteristics of the donors accepted in our Center by means of donor/recipient (D/R) size, and to determine its relationship in the development of primary graft dysfunction (PGD). We analyzed the impact of PGD on 30 day mortality and survival (conditional) at 1 year. Methods Retrospective analysis of D/R heart transplant (HT) pairing from January 2006 to August 2017. ISHLT criteria was considered to describe PGD, dividing our cohort whether they developed PGD or not. Variables were compared using the Mann Whitney U or x2 tests. ROC curves were used to determine the predictive value of the difference between D/R weight, BMI and heart mass (HM). Survival was analyzed with the Kaplan Meier curves and LogRank test. Results We analyzed 256 HT recipients, 71% male, and 67% had ischemic and idiopathic cardiomyopathy. The prevalence of PGD was 27% and 51% had severe PGD. A difference in baseline serum creatinine values was observed, even though these values were between the normal range (p=0.04). The development of PGD was significantly associated to 30 day mortality (p 0.05). Weight had a strong correlation in the donor and recipient's HM (p Conclusion The interaction between D/R is crucial to obtain good results after the transplant. In our Center, the selection of donors has been very strict, donor undersizing by HM was not detected. Overall, HM and size of the D/R is not associated with the PGD. Using a single method with added value, like HM, we could avoid the usual limitations of the simple variables.