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  • Human Society
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  • Selective Angiography Of Stimulant-exposed Cardiac Donors Following Circulatory Death Does Not Impact Post-transplant Outcomes.
  • Human Society
  • Criminology
  • Victims
  • Selective Angiography Of Stimulant-exposed Cardiac Donors Following Circulatory Death Does Not Impact Post-transplant Outcomes.

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    Selective Angiography of Stimulant-Exposed Cardiac Donors Following Circulatory Death Does Not Impact Post-Transplant Outcomes.

    Clayton J Rust1, Ross Michael Reul1, Helen Abadiotakis1

    • 1Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA 30345, USA.

    Journal of Clinical Medicine
    |June 13, 2025

    View abstract on PubMed

    Summary
    This summary is machine-generated.

    Omitting routine coronary angiography in stimulant-exposed heart donors after circulatory death (DCD) did not impact transplant outcomes. However, a selective approach for high-risk donors, like those with diabetes, may be beneficial.

    Keywords:
    amphetaminecocainedonation after circulatory deathdonor selectionleft heart catheterization

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    Area of Science:

    • Cardiology
    • Transplant Surgery
    • Public Health

    Background:

    • Donation after circulatory death (DCD) expands the heart donor pool but often includes donors with stimulant use risk factors.
    • Stimulant use can lead to coronary artery disease, necessitating coronary screening via left heart catheterization (LHC).
    • Performing LHC in DCD donors presents logistical challenges.

    Purpose of the Study:

    • To evaluate the impact of omitting antemortem left heart catheterization (LHC) in stimulant-exposed DCD heart donors on transplant recipient outcomes.
    • To determine if a selective LHC approach could optimize donor pool expansion.

    Main Methods:

    • Retrospective analysis of the United Network for Organ Sharing (UNOS) database (2019-2024).
    • Identified adult heart transplant recipients from DCD donors with documented cocaine or amphetamine use.
    • Stratified donors by antemortem LHC performance; analyzed 1-year recipient survival, graft failure, and acute rejection.

    Main Results:

    • No significant differences in 1-year survival, graft failure, or complications were observed between LHC and non-LHC cohorts (n=485).
    • Omitting LHC in stimulant-exposed DCD donors was safe overall.
    • However, in stimulant-exposed DCD donors with diabetes, the absence of LHC was linked to higher recipient mortality (HR 5.86).

    Conclusions:

    • Routine LHC may be unnecessary for stimulant-exposed DCD heart donors without additional risk factors.
    • Selective LHC for high-risk DCD donors, such as those with diabetes, could safely expand the donor pool.
    • This strategy balances donor utilization with recipient safety.