What question did this study set out to answer?

To compare donor risk acceptance between Europe and North America and determine how donor-recipient risk matching impacts one-year graft failure.

May 1, 2023Circulation Heart FailureOpen Access

Rethinking Donor and Recipient Risk Matching in Europe and North America: Using Heart Transplant Predictors of Donor and Recipient Risk

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To compare donor risk acceptance between Europe and North America and determine how donor-recipient risk matching impacts one-year graft failure.
Analyzed heart transplant recipients and donors from the International Society for Heart and Lung Transplantation registry between 2000 and 2018.
Quantified donor quality using the Donor Utilization Score (DUS) and recipient risk using the Index for Mortality Prediction After Cardiac Transplantation score.
Assessed one-year freedom from graft failure using multivariable Cox proportional hazard regression and Kaplan-Meier analyses across four risk-pairing groups.
European centers accepted significantly higher-risk donor hearts than North American centers (mean DUS 0.45 vs 0.54, P <0.005), with DUS independently predicting graft failure (P <0.001).
One-year graft failure in North America was lowest for low-risk donor and low-risk recipient pairs (7.4% [95% CI, 6.8%–8.0%]) and highest for high-risk pairs (13.1% [95% CI, 10.7%–13.9%]; log-rank P <0.001).
Pairing high-risk donors with low-risk recipients yielded significantly less graft failure (9.0% [95% CI, 8.3%–9.7%]) than pairing low-risk donors with high-risk recipients (11.4% [95% CI, 10.7%–12.2%]).

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Implication

Cohort study reveals lower graft failure when high-risk donor hearts are matched with low-risk recipients, suggesting strategic allocation can safely increase donor heart utilization.

Cite This Study

Moayedi et al. (2023) studied this question.

synapsesocial.com/papers/6a9b9f8cfc9a6d44aa6bea2c https://doi.org/10.1161/circheartfailure.122.009994

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Implication

Cohort study reveals lower graft failure when high-risk donor hearts are matched with low-risk recipients, suggesting strategic allocation can safely increase donor heart utilization.

Rethinking Donor and Recipient Risk Matching in Europe and North America: Using Heart Transplant Predictors of Donor and Recipient Risk

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Discussion

Implication

Cite This Study

Rethinking Donor and Recipient Risk Matching in Europe and North America: Using Heart Transplant Predictors of Donor and Recipient Risk

Key Points

Discussion

Implication

Cite This Study

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