Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Purpose: To evaluate cardiac recipient survival and incidence of coronary artery vasculopathy (CAV) in recipient hearts that have been exposed to lung preservation solution, Perfadex.
Methods: The UNOS database from 2007-2014 was retrospectively reviewed for: 1) donor hearts procured alone or 2) procured with lungs was performed. For donor hearts procured with lungs, hearts were a grouped by exposure or no exposure to Perfadex. Weighted Inverse-propensity scores were used to control for the baseline covariates of donor/recipient age, gender, diabetes, African America (AA), and ischemic time. Survival curves for five-year survival and time to CAV were compared using the generalized Wilcoxon test.
Results: Of 22,337 donor hearts, 8,360 (37.4%) were procured with lungs with 7,386 (88.4%) of them exposed to Perfadex. The remaining 13,977 (62.6%) of donor hearts were procured alone and were not exposed to Perfadex. The majority of these donor hearts were male (D/R), not AA, and not diabetic. Heart-only recipients and donors were younger than donors procured with lungs (28.2 vs. 27.9 and 43.5 vs. 47.9 years (y).
5 year survival for donor hearts procured with lungs is 0.763 (95% CI: 0.752, 0.775) vs 0.744 (95% CI: 0.735, 0.753) for donor hearts procured without lungs (p=0.0098). In donor hearts procured without lungs the probability of not having a CAV at 5 years post-transplantation was 0.943 (95% CI: 0.938, 0.948) vs 0.930 (95% CI: 0.922, 0.938) in donor hearts procured with lungs (p=0.0084). Those that were not exposed have nearly 96% chance of being free from a CAV versus a 92.8% if they were exposed (p= .0009) at 5y. Conclusion: Donor heart exposed to perfadex have a higher 5y incidence of CAV.
CITATION INFORMATION: Copeland H, Garcia V, Sima A, Baran D, Mankind A, Katlaps G, Lewis N, Dharmaj B, Copeland J. Lung Preservation Solution Exposure at Cardiac Procurement Is Associated Increased Incidence of Coronary Arterial Vasculopathy. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Copeland H, Garcia V, Sima A, Baran D, Mankind A, Katlaps G, Lewis N, Dharmaj B, Copeland J. Lung Preservation Solution Exposure at Cardiac Procurement Is Associated Increased Incidence of Coronary Arterial Vasculopathy. [abstract]. Am J Transplant. 2017; 17 (suppl 3). http://atcmeetingabstracts.com/abstract/lung-preservation-solution-exposure-at-cardiac-procurement-is-associated-increased-incidence-of-coronary-arterial-vasculopathy/. Accessed November 18, 2017.
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