Chronic alcoholic donors in heart transplantation: A mortality meta-analysis

Jacob, Kirolos A.; Heer, Linda M. de; Heer, Frederiek de; Kluin, Jolanda

doi:10.1016/j.ijcard.2015.04.253

Cited by 11 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies of human donors and alcohol consumption show conflicting outcomes – some suggest benefit, others detrimental, all are small studies . A study in 2015 using the United Network for Organ Sharing database was examined for all primary, adult heart transplants carried out from 2005 to 2012 incorporating 2274 heavy drinking donors (defined as 2+ drinks/day) – there was no adverse effect on mortality , and that has been confirmed even more recently . These studies do not adequately address the issue of dose and duration‐related effects of alcohol.…”

Section: Cardiothoracic Transplantation Outcomes With Alcoholmentioning

confidence: 99%

Effects of drug abuse, smoking and alcohol on donor hearts and lungs

et al. 2019

View full text Add to dashboard Cite

Potential heart and lung donors with a history of illicit drugs and/or smoking and alcohol are frequently offered, though there is no clear guidance on when it is safe to use these organs. A review of the literature on effects of drugs, alcohol and smoking on donor outcomes, and the effects of these on the intact heart and lung was undertaken. There has been a marked increase in deaths from opioid abuse in many developed countries, though recent evidence suggests that outcomes after cardiothoracic transplantation are equivalent to nonopioid donor causes of death. For donor smoking, there is an increased risk with lung transplantation; however, that risk is less when compared to further waiting on the transplant list for a nonsmoking alternative. Heavy alcohol consumption does not adversely affect heart transplantation, and there is no clear evidence of adverse outcomes after lung transplantation. There are no overall effects of cannabis or cocaine on survival after heart or lung transplantation. In all these cases, careful donor assessment can establish if a particular organ can be used. In most cases, use of drugs requires careful assessment, but is not in of itself a contraindication to cardiothoracic transplantation.

show abstract

Section: Cardiothoracic Transplantation Outcomes With Alcoholmentioning

confidence: 99%

Effects of drug abuse, smoking and alcohol on donor hearts and lungs

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Current International Society the Heart and Lung transplantation (ISHLT) guidelines recommend against the use of hearts from donors that abuse alcohol . While early studies reported poor outcomes following HTx using hearts from alcoholic donors, more recent data refute these findings . A large registry study reported no mortality difference among recipients of alcoholic donor hearts; however, the impact of donor alcohol abuse (AA) on cardiac allograft function, rhythm, and recipient functional status was not evaluated.…”

Section: Introductionmentioning

confidence: 99%

The effect of donor alcohol abuse on outcomes following heart transplantation

Newman

Liebo

Lowes

et al. 2019

Clinical Transplantation

View full text Add to dashboard Cite

Background: Current guidelines recommend against the use of hearts from donors that abuse alcohol. We explored the effect of donor alcohol abuse (AA) on cardiac allograft function and outcomes in heart transplant (HTx) recipients. Methods:Overall, 370 HTx recipients were divided into two groups: (a) the alcoholic donor group (AD, n = 58) and (b) the non-alcoholic donor group (NAD, n = 312). Results:Recipients in the AD group had a slower heart rate (86 ± 13 vs 93 ± 13, P = 0.004) and an increased incidence of early atrial fibrillation (AF) (30% vs 11%, P = 0.003). Echocardiographic left ventricular mass was higher among alcoholic donors (171.7 ± 66.7 vs 151.6 ± 54.7, P = 0.02). This difference remained present 1 year following HTx (185 ± 43 vs 166 ± 42, P = 0.007). E/E′ was higher in the AD group (9.5 ± 3.9 vs 8.4 ± 2.9, P = 0.04) and a larger number of AD recipients had a ventilatory equivalent for VCO 2 > 34 (50% vs 31%, P = 0.04) on cardiopulmonary exercise test. There was no significant difference in rejection, cardiac allograft vasculopathy (CAV), or survival between the groups. Conclusions:Our data suggest that donor AA does not impact rejection, CAV, or intermediate-term survival, but may cause increased incidence of post-HTx AF and impaired cardiac allograft diastolic function. K E Y W O R D Satrial fibrillation, diastolic dysfunction, donor characteristics, heart transplantation

show abstract

“… 16 Lastly, allografts from donors with alcohol use disorders might be avoided because of the risks of alcoholic cardiomyopathy, but evidence has shown that with careful screening and selection, allografts from donors with alcohol use disorders can be used with equivalent outcomes barring any pretransplant cardiac dysfunction. 28 The evidence behind the donor selection behaviors found in the present study are insufficient and poorly predictive of post‐HTx outcomes, and limiting selection to donor characteristics with clear supportive evidence may decrease waitlist times and improve waitlist outcomes for patients listed as status 1A.…”

Section: Discussionmentioning

confidence: 74%

Donor Characteristics and Recipient Outcomes After Heart Transplantation in Adult Congenital Heart Disease

Huntley

Danford

Menachem

et al. 2021

JAHA

View full text Add to dashboard Cite

Background Patients with adult congenital heart disease (ACHD) experience long waitlist times for heart transplantation (HTx) while a large proportion of donor hearts are refused. The goal of this study was to inform optimal donor selection for patients with ACHD listed for HTx by examining the impact of donor characteristics on post‐HTx outcomes. Methods and Results Using the Scientific Registry of Transplant Recipients, we conducted a retrospective analysis of patients aged ≥18 years listed for HTx in the United States between 2000 and 2016. We compared waitlist times between patients with ACHD and patients with noncongenital heart disease and constructed multivariate hazard models to identify donor characteristics associated with increased waitlist time. We then compared post‐HTx survival between patients with ACHD and patients with noncongenital heart disease and constructed multivariate hazard models to identify donor characteristics associated with mortality. There were very few differences in donor characteristics between HTx recipients with ACHD and those with noncongenital heart disease. Status 1A–listed patients with ACHD experienced longer waitlist times compared with patients with noncongenital heart disease. Increased wait times were associated with some donor characteristics. Post‐HTx outcomes varied over time, with patients with ACHD having inferior early mortality (0 to 30 days), similar intermediate mortality (31 days to 4 years), and superior late mortality (>4 years). We identified no donor characteristics associated with mortality to justify the observed differences in donor selection or waitlist time. Conclusions HTx candidates with ACHD wait longer for transplant but do not require unique donor selection criteria. HTx teams should consider liberalizing donor criteria and focusing only on evidence‐based selection to improve waitlist outcomes and reduce the recipient–donor disparity.

show abstract

Chronic alcoholic donors in heart transplantation: A mortality meta-analysis

Cited by 11 publications

References 9 publications

Effects of drug abuse, smoking and alcohol on donor hearts and lungs

Effects of drug abuse, smoking and alcohol on donor hearts and lungs

The effect of donor alcohol abuse on outcomes following heart transplantation

Donor Characteristics and Recipient Outcomes After Heart Transplantation in Adult Congenital Heart Disease

Contact Info

Product

Resources

About