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Use of Cardiac Allografts With Mild and Moderate Left Ventricular Hypertrophy Can Be Safely Used in Heart Transplantation to Expand the Donor Pool
- Source :
- Journal of the American College of Cardiology. 51(12):1214-1220
- Publication Year :
- 2008
- Publisher :
- Elsevier BV, 2008.
-
Abstract
- ObjectivesThe purpose of this study was to evaluate outcomes of heart transplantation (HTx) and changes in left ventricular wall thickness (LVWT) post-HTx using donors with left ventricular hypertrophy (LVH).BackgroundLimited data are available on use of donor hearts with LVH in HTx.MethodsWe reviewed 427 patients who underwent HTx: 62 received hearts with LVH (interventricular septum [IVS] or posterior wall [PW] thickness ≥1.2 cm) by echocardiography, and 365 received hearts without LVH. The median follow-up was 3.8 years (range 0 to 16.2 years).ResultsRecipient age was 56 ± 11 years and donor age was 30 ± 12 years. Baseline recipient characteristics were similar in both groups. Donors with LVH were older (35 ± 12 years vs. 29 ± 12 years, p = 0.001) and had higher rates of intracranial hemorrhage (38% vs. 15%, p = 0.001). The LVWT was increased in the LVH group compared with LVWT in the non-LVH group (IVS: 1.28 ± 0.18 cm vs. 0.85 ± 0.19 cm, PW: 1.27 ± 0.19 cm vs. 0.85 ± 0.20 cm, p = 0.0001 for both groups). Mild LVH (1.2 to 1.3 cm) was found in 42%, moderate (>1.3 to 1.7 cm) in 53%, and severe (>1.7 cm) in 5% of donors with LVH. Left ventricular wall thickness regression occurred in both IVS and PW (1.28 ± 0.18 cm vs. 1.10 ± 0.13 cm vs. 1.13 ± 0.14 cm, and 1.27 ± 0.19 cm vs. 1.11 ± 0.11 cm vs. 1.13 ± 0.14 cm, at baseline, 1 year, and 5 years, respectively; p < 0.001 for change from baseline to 1 and 5 years for both locations). Patients with or without donor LVH had similar 1-year (3.5% vs. 9.5%, p = 0.2) and 5-year survival rates (84 ± 5.9% vs. 70 ± 2.7%, p = 0.07).ConclusionsShort- and long-term survival rates and rates of LVH at follow-up were similar in both groups, suggesting that donor hearts with mild and moderate LVH can be safely used in HTx.
- Subjects :
- Adult
Male
medicine.medical_specialty
Tissue and Organ Procurement
Adolescent
Heart Ventricles
medicine.medical_treatment
Left ventricular hypertrophy
Severity of Illness Index
Muscle hypertrophy
Internal medicine
Severity of illness
medicine
Humans
Transplantation, Homologous
cardiovascular diseases
Interventricular septum
Survival rate
Heart transplantation
business.industry
Middle Aged
medicine.disease
Tissue Donors
Surgery
Survival Rate
Transplantation
Treatment Outcome
medicine.anatomical_structure
Echocardiography
Circulatory system
Cardiology
Heart Transplantation
Female
Hypertrophy, Left Ventricular
business
Cardiology and Cardiovascular Medicine
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 51
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....73af3713c4777ab60b20d8abae4e7b5b
- Full Text :
- https://doi.org/10.1016/j.jacc.2007.11.052