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Transplantation with Nonstandard Donor Hearts: Single Center Experience in Central China
Qianhai Huang1, Junlong Hu1, Zhigao Chen1
1Department of Cardiovascular Surgery, Fuwai Central China Cardiovascular Hospital, Henan Provincial People's Hospital Heart Center, Zhengzhou University Central China Fuwai Hospital, Zhengzhou, Henan, China.
Insights
Marginal donor hearts, used to address donor shortages in heart transplantation, showed similar short-term outcomes compared to conventional donor hearts. This approach offers a viable option without compromising patient recovery or survival.
Area of Science:
- Cardiology
- Transplant Surgery
- Organ Donation
Background:
- Rising waiting list mortality and donor shortages necessitate the use of marginal donor hearts for end-stage heart failure.
- Clear guidelines for risk prevention and management in marginal donor heart transplantation are lacking.
Purpose of the Study:
- To evaluate the outcomes of heart transplantation using marginal donor hearts.
- To compare the efficacy and safety of marginal donor hearts versus conventional donor hearts.
Main Methods:
- Retrospective analysis of 44 heart transplant recipients (October 2019 - March 2024).
- Patients divided into marginal donor heart (n=30) and conventional donor heart (n=14) groups.
- Comparison of clinical data, postoperative recovery, and short-term survival.
Main Results:
- No significant differences in postoperative hospitalization, ICU stay, left ventricular ejection fraction, or biochemical indicators between groups.
- One- and 3-month follow-up revealed comparable left ventricular ejection fraction, biochemical indicators, and mortality rates.
- Five deaths occurred within the 3-month follow-up period, with no significant difference in mortality between the groups.
Conclusions:
- Marginal donor hearts can help mitigate donor heart scarcity.
- The use of marginal donor hearts does not significantly compromise short-term patient survival or recovery compared to conventional donors.
Background:
Recently, marginal donor hearts have been applied to patients with end-stage heart failure due to rising waiting list mortality and increasing demand for donors. However, the principles of risk prevention and the usage of marginal donor hearts have yet to be clearly defined.
Methods:
A retrospective analysis was performed to investigate the outcomes of patients undergoing heart transplantation at our center between October 2019 and March 2024. Forty-four patients were enrolled and divided into the marginal donor heart group (n = 30) and the conventional donor heart group (n = 14) according to the classification criteria. The clinical data between the 2 groups were compared and analyzed.
Results:
There were no statistically significant differences in the postoperative length of hospitalization, ICU stay, left ventricular ejection fraction, or serum biochemical indicators between the 2 groups. Five patients died during the 3-month follow-up period. Notably, 1- and 3- month postoperative follow-up showed no significant differences in left ventricular ejection fraction, serum biochemical indicators, and mortality between the 2 groups CONCLUSION: The application of marginal donor hearts can partially alleviate the shortage of donor heart resources. It did not significantly affect patients' short-term survival or recovery.
