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The outcomes of marginal donor hearts compared with ideal donors: a single-center experience in Iran
Behnam Shakerian1, Sanaz Dehghani2,3, Haleh Ashraf4
1Department of Cardiovascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Insights
This study compared survival outcomes of marginal versus ideal donor hearts in Iran. Recipients of marginal donor hearts showed slightly lower survival, suggesting potential for using marginal donors for select patients.
Area of Science:
- Cardiology
- Transplant Surgery
- Public Health
Background:
- Heart transplantation is the standard treatment for end-stage heart failure.
- Organ scarcity is a significant challenge in Iran.
- This study evaluates the use of marginal donor hearts in Iranian heart transplant recipients.
Purpose of the Study:
- To compare the survival outcomes of marginal donor hearts versus ideal donor hearts in Iran.
- To assess the feasibility of using marginal donors to address organ shortages.
- To inform policy regarding organ donation and transplantation in Iran.
Main Methods:
- Retrospective study analyzing follow-up data of heart donors and recipients.
- Categorization of 93 participants into ideal (n=75) and marginal (n=18) donor groups.
- Comparison of post-transplant survival between recipients of ideal and marginal donor hearts.
Main Results:
- Donor age was significantly associated with marginal donor status.
- Recipient age impacted survival days in the ideal donor group.
- Median survival was 645 days for marginal donor recipients and 689 days for ideal donor recipients.
Conclusions:
- Utilizing marginal donors for carefully selected marginal recipients could help alleviate organ shortages in Iran.
- Establishing a national marginal donor system is recommended to expand the donor pool.
- This approach may reduce waitlist times for heart transplantation in Iranian patients.
Background:
Heart transplantation has been considered the gold-standard treatment for patients with end-stage heart failure. This study assessed the survival outcomes of marginal donor hearts compared with ideal donor hearts in Iran.
Methods:
This retrospective study is based on the follow-up data of heart donors and recipients in the Sina Hospital Organ Procurement Unit. Among the 93 participants, 75 were categorized as ideal donors (group A) and 18 as marginal donors (group B). Group C included heart recipients who received a standard organ, and group D included heart recipients who received a marginal one. To analyze differences in patient characteristics among the groups, posttransplant heart survival was assessed in all groups. All data were obtained from the hospital records.
Results:
The mean age of the donors was 26.27±11.44 years (median age, 28 years). The marginal age showed a significant association with donor age. The age of recipients had a significant effect on survival days in the ideal group. Most patients survived for at least 1 year, with a median of 645 days in recipients from marginal donors and 689 days in recipients from ideal donors.
Conclusions:
Considering the lack of organ availability in Iran, it may be possible to use marginal donors for marginal recipients, therefore reducing the number of people on the waitlist. We also recommend establishing a national marginal donor system specifically for Iranian patients to extend the donor pool.
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