Does the Method for Dual Procurement of Heart and Lung Allografts Have an Impact on the Occurrence of Donor-Derived...

Donor-derived infections (DDI) represent an inherent risk associated with significant morbidity and mortality in heart transplantation. This study investigated the impact of combined cardiopulmonary donation and the method of dual heart-lung procurement on DDI incidence and short-term outcomes in cardiac transplantation.

This single-center retrospective study included patients who underwent heart transplantation from January 2021 to February 2025. We excluded multi-organ transplant recipients and recipients receiving donor hearts procured outside Zhongnan Hospital of Wuhan University. Recipients were divided into heart-only procurement group and heart-lung procurement group. The methods of heart-lung procurement were classified as synchronous or sequential procurement. Primary outcomes were the incidence and prognosis of postoperative infection and DDI. Comparisons utilized t-tests, Chi-squared tests, Mann-Whitney U tests, or Fisher's exact tests. p < 0.05 was considered statistically significant.

No significant differences were observed in mechanical circulatory support rates, postoperative infection rates, length of hospital stay, or 30-day mortality between the heart-only procurement group (n = 33) and heart-lung procurement group (n = 38). One recipient in the synchronous procurement subgroup developed DDI caused by donor respiratory pathogens; and the overall incidence of DDI at our center was 0.862%. This patient died from septic shock 52 days post-transplantation.

Combined cardiopulmonary donation did not significantly affect the perioperative prognosis of heart transplantation. However, synchronous procurement might increase the risk of DDI derived from respiratory pathogens, which is a rare but fatal complication. Sequential procurement has the potential to avoid this risk and should be the preferred method for dual procurement.