Donor Electrocardiogram Associations With Cardiac Dysfunction, Heart Transplant Use, and Survival: The Donor Heart...

Area of Science:

• Cardiology
• Transplantation Medicine
• Critical Care Medicine

Background:

• Electrocardiogram (ECG) abnormalities are common in potential organ donors after brain death.
• The clinical significance and prognostic value of these ECG findings remain largely unknown.

Purpose of the Study:

• To determine the prevalence of ECG abnormalities in potential cardiac donors.
• To investigate the association of these abnormalities with cardiac dysfunction, heart transplantation (HT) utilization, and recipient outcomes.

Main Methods:

• A nationwide cohort of 4,333 potential cardiac organ donors was analyzed.
• ECGs were interpreted by blinded experts and repeated 24 ± 6 hours after initial assessment.
• Statistical regression models assessed associations with cardiac findings, HT use, and graft survival.

Main Results:

• Of 4,136 interpretable ECGs, 64% showed abnormalities, most commonly nonspecific St-T-wave changes, T-wave inversion, or prolonged QTc interval.
• Pathologic Q waves were the only significant predictor of donor heart nonuse (adjusted OR: 0.39).
• No ECG abnormalities were associated with graft survival at 1 year post-HT.

Conclusions:

• ECG abnormalities are prevalent in potential heart donors but frequently transient.
• Pathologic Q waves are linked to decreased likelihood of heart transplantation but do not negatively affect long-term graft survival.