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Performing diagnostic coronary angiography to evaluate high-risk cardiac donors: A French nationwide cohort study

“…DTCA significantly worsens heart transplantation outcome [7,9,10]. Grafts with multiple vessel CAD are at serious risk of early graft failure, yet the short-and long-term prognosis of single vessel CAD hearts is not different from grafts without CAD, suggesting that these hearts may further increase the pool of available grafts [6]. CA is useful in determining donors' coronary status, thus reducing the risk of DTCA and performing systematic CA in ECD may be a real answer to organ shortage.…”

“…This score could be used in addition to other heart donor scores such as Eurotransplant that accurately reflects the likelihood of organ acceptance and predicts long-term mortality [7,15]. In case of false negative, the explanting surgeon could still detect CAD and revascularization by internal mammary coronary artery bypass grafting during the transplantation procedure or percutaneous coronary intervention after the transplantation should be considered [6,18,28].…”

“…Increased donor age is associated with the presence of cardiovascular risk factors and rising coronary artery disease (CAD) prevalence. Therefore, there is a greater risk for donortransmitted coronary atherosclerosis (DTCA), which may dramatically impact recipients' survival [6,7]. DTCA is a risk factor for primary graft dysfunction and seems to increase the risk of allograft vasculopathy, a major cause of morbi-mortality in heart transplant recipients [8][9][10][11].…”