Related Experiment Video
Updated: Dec 12, 2025
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
A single-center long-term experience with marginal donor utilization for heart transplantation
Antonella Galeone1, Guillaume Lebreton1, Guillaume Coutance1
1Department of Thoracic and Cardiovascular Surgery, Groupe Hospitalier Pitié-Salpêtrière, APHP, Sorbonne Université, Paris, France.
Background:
To evaluate the early and late outcome of heart transplantation (HT) using marginal (MDs) and optimal donors (ODs).
Methods:
Clinical records of recipients transplanted between July 2004 and December 2014 were retrospectively reviewed. MDs were defined as follows: age >55 years, high-dose inotropic support, left ventricular ejection fraction <45%, left ventricular hypertrophy, donor to recipient predicted heart mass ratio <0.86, ischemic time >4 hours.
Results:
A total of 412 (55%) recipients received an organ from a MD; recipients who received an organ from an OD had less primary graft dysfunction (PGD) (25% vs 38%; P < .001), less acute renal failure (23% vs 34%; P < .001), and higher survival rates (90.2% vs 81.8% at 30 days, 79.5% vs 71.1% at 1 year, 51.8% vs 45.4% at 12 years; P = .01) than recipients who received an organ from a MD. There was no statistically significant difference in 30-day conditional survival between the two groups (survival rates 57.4% vs 55.5% at 12 years; P = .43). PGD, perioperative hemodialysis, and sepsis were independent risk factors of mortality at multivariate analysis.
Conclusions:
Utilization of MDs for HT is associated with a higher incidence of PGD and acute renal failure, and a reduction of 30-day survival.
