Waiting for the Optimal Donor for MCS Patients Awaiting Heart Transplant
Cedars Sinai Medical Center, Los Angeles.
Meeting: 2018 American Transplant Congress
Abstract number: 256
Keywords: Age factors, Donors, unrelated, Weight
Session Information
Session Name: Concurrent Session: Location, Location, Allocation in Heart Transplantation
Session Type: Concurrent Session
Date: Monday, June 4, 2018
Session Time: 2:30pm-4:00pm
Presentation Time: 3:06pm-3:18pm
Location: Room 4C-3
Purpose: Patients (pts) bridged with mechanical circulatory support (MCS) may require more optimal donors for best outcome compared to non-bridged transplant recipients. MCS pts have more bleeding due to scar tissue and administration of blood products can potentially overwhelm the RV of the donor heart causing right heart failure. Physicians may prefer a pristine, potentially larger donor, to accommodate excess bleeding and other complications. Prior to MCS, physicians would take donor hearts even with high risk factors for their very ill pts. In the present era, we place these very ill patients on MCS thus making them stable and better candidates for HTx. However, as a result, high risk donors are no longer being taken for these pts, and they may wait for a more low-risk donor heart. We assessed whether MCS pts did require a low-risk type donor compared to non-MCS pts.
Methods: We assessed 5,826 status 1A pts awaiting HTx using the UNOS STAR file. Pts were divided into those with MCS (n=3121) and those without MCS (n=2705). Donor hearts were characterized by donor age, gender and BMI between both groups. We also determined percent of donor/recipient male into male, male into female, female-male, female-female pairs.
Results: MCS pts awaiting HTx compared to non-MCS had similar donor age. However, the gender of donors for MCS pts was significantly more male than female. Days to HTx was significantly longer in MCS pts. Donors for the MCS pts were significantly taller than the non-MCS pts. Post tx outcomes were similar.
Conclusion: MCS pts awaiting HTx had significantly longer time in days to transplant and appeared to require a higher percentage of (larger) male donors into male recipients. This suggests that HTx physicians are more selective to obtain a more optimal donor for their MCS pts.
| Status 1a and MCS (n=3121) | Status 1a and No MCS (n=2705) | P-Value | |
| Donor Age (Yrs), mean, SD | 31.7, 10.8 | 31.9, 11.2 | 0.549 |
| Total Days on Waiting List, mean, SD | 315.7, 419.6 | 137.0, 270.3 | <0.001 |
| Recipient Age, mean, SD | 52.8, 12.5 | 53.2, 13.4 | 0.229 |
| DON/REC, % | |||
| Male/Male | 69.9 | 56.9 | <0.001 |
| Male/Female | 8 | 12.1 | |
| Female/Female | 10.1 | 16.5 | |
| Female/Male | 12 | 14.5 | |
| Donor BMI, mean ± SD | 28.0 ± 6.0 | 27.1 ± 5.8 | <0.001 |
CITATION INFORMATION: Kobashigawa J., Patel J., Kransdorf E., Levine R., Dimbil S., Passano E., Czer L., Moriguchi J., Arabia F. Waiting for the Optimal Donor for MCS Patients Awaiting Heart Transplant Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kobashigawa J, Patel J, Kransdorf E, Levine R, Dimbil S, Passano E, Czer L, Moriguchi J, Arabia F. Waiting for the Optimal Donor for MCS Patients Awaiting Heart Transplant [abstract]. https://atcmeetingabstracts.com/abstract/waiting-for-the-optimal-donor-for-mcs-patients-awaiting-heart-transplant/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress