Impact of Dcd Donor Hearts on Transplant Outcomes: A Propensity-Matched Analysis.

Orthotopic heart transplantation (OHT) remains the gold standard for advanced heart failure. Two pathways exist to deceased donor heart graft donation: Traditional brain-dead donor (DBD) and recently donation after circulatory death (DCD). However, the impact of DCD donor hearts on the outcome of adult OHT recipients remains unclear. The aim of this study was to compare the outcome of adult OHT recipients between DCD and DBD donor grafts. Data were obtained from single center institutional database. All adult patients undergoing OHT from September 2019 through September 2021 were included (n = 165). Propensity scores for DCD donors were calculated. Patients were matched 1:1 based on the propensity score of each patient. The impact of DCD donors on post-transplant outcomes was investigated. Overall survival probability analysis was performed. From September 2019 through September 2021, 165 OHTs were performed. DCD donors accounted for 36 (21.8%). Following matching, 72 patients were available for analysis. There were no significant differences in baseline characteristics between DCD and DBD recipients. ISHLT primary graft dysfunction (63.89% vs 75% p=0.31) and need for mechanical circulatory support (IABP and ECMO) (16.67% vs. 33.33% p = 0.10) occurred less commonly amongst DCD cases but was not statistically significant. There were no differences in hospital length of stay (15 vs 16 days p=0.44), median left ventricular ejection fraction at 90 days (61% vs 63.5% p=0.45), and 90-day survival (100% vs 91.67% p=0.07). One year survival (100% vs 89.66 p=0.08) and Kaplan Meier survival analysis were not statistically significant between groups (p = 0.303) (Figure). Cardiac allograft vasculopathy at 1 year was similar (61.5% vs. 67.86% p=0.63). DCD heart grafts yielded similar outcomes when compared to a matched DBD cohort. Increased use of DCD donor grafts can potentially alleviate the persistent shortage of available donor organs and shorten the waitlist time for heart transplantation. [ABSTRACT FROM AUTHOR]