Background: Donor methamphetamine (meth) use has been a relative contraindication for the use of the donor hearts for patients awaiting heart transplantation. The concern is that meth use may increase the likelihood of underlying cardiomyopathy, coronary artery disease and/or coronary spasm which may damage the donor heart. There is also concern for endothelial cell dysfunction in patients with meth abuse, which may also lead to an increased development of cardiac allograft vasculopathy (CAV). Therefore, we sought to assess patients whose donors had used meth actively or some time in the past.

Methods: Between 2010 and 2014 we evaluated heart transplant patients who had received donors with an active and previous history of meth use. Active meth use was defined as use of cocaine within the preceding 3 months of organ donation. A group of patients without a history of meth use from the same period of time was set as a control. Endpoints of this study included 1-year survival, freedom from CAV as defined by stenosis ≥ 30% by angiography, freedom from Non-Fatal Major Adverse Cardiac Events (NF-MACE: myocardial infarction, new congestive heart failure, percutaneous coronary intervention, implantable cardioverter defibrillator/pacemaker implant, stroke), and freedom from any treated rejection.

Results: There was no significant difference observed in all three groups for 1-year survival, freedom from CAV, freedom from NF-MACE and any treated rejection.

Conclusion: Donor hearts with an active or previous history of methamphetamine use does not appear to be a contraindication to heart transplantation. A longer follow-up period is needed to confirm these early observations.

CITATION INFORMATION: Kittleson M, Patel J, Czer L, Velleca A, Aintablian T, Chang D, Esmailian F, Kobashigawa J. Is Donor Methamphetamine Use a Contraindication in Heart Transplantation? Am J Transplant. 2016;16 (suppl 3).

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