The impact of donor-recipient age difference on graft survival after heart transplant in adults with congenital heart disease
Background: The impact of donor-recipient age difference in adult congenital heart disease (ACHD) patients undergoing heart transplant (HT) is unknown. Methods: ACHD patients (≥18 years old) who underwent HT (2000-2020) were identified using the United Network for Organ Sharing database. Graft survi...
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Elsevier
2024-11-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133424000843 |
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| author | William H. Marshall, V, MD Brent C. Lampert, DO Curt J. Daniels, MD Deipanjan Nandi, MD Lydia K. Wright, MD |
| author_facet | William H. Marshall, V, MD Brent C. Lampert, DO Curt J. Daniels, MD Deipanjan Nandi, MD Lydia K. Wright, MD |
| author_sort | William H. Marshall, V, MD |
| collection | DOAJ |
| description | Background: The impact of donor-recipient age difference in adult congenital heart disease (ACHD) patients undergoing heart transplant (HT) is unknown. Methods: ACHD patients (≥18 years old) who underwent HT (2000-2020) were identified using the United Network for Organ Sharing database. Graft survival through 10 years based on donor-recipient age difference was evaluated by comparing outcomes of donors >5 years older than recipients (Older), donors within 5 years of recipient age (Equal Age), and donors >5 years younger than recipients (Younger, reference group). Cox multivariable analysis was performed to evaluate the effect of donor-recipient age difference on early and late graft survival. Results: A total of 1,275 ACHD patients underwent HT (60% male, median 35 years old (interquartile range 24-46) with median graft survival of 13.7 years (95% confidence interval [CI] 11.7-16.0). Compared to Younger donors (n = 306 [24%]), graft survival was similar with Equal Age donors (n = 698 [55%]; log-rank p = 0.61), though significantly reduced with Older donors (n = 271 [21%]; log-rank p = 0.03). In multivariable analysis, late graft survival was similar with Equal Age donors but lower with Older donors (adjusted hazard ratio 1.63, 95% CI 1.16-2.28, p = 0.005), with a trend of reduced survival with Older donors in recipients <30 or ≥40 years old. Conclusions: Graft survival in ACHD patients undergoing HT was similar for those with Younger and Equal Age donors. Recipients with Older donors had reduced 10-year survival, possibly related to increased risk in those <30 and ≥40 years old. These data help inform the optimal donor age for ACHD patients requiring HT. |
| format | Article |
| id | doaj-art-2a45d8bf24e94fdb9d35fdec6eb6644a |
| institution | OA Journals |
| issn | 2950-1334 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
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| series | JHLT Open |
| spelling | doaj-art-2a45d8bf24e94fdb9d35fdec6eb6644a2025-08-20T02:12:46ZengElsevierJHLT Open2950-13342024-11-01610013510.1016/j.jhlto.2024.100135The impact of donor-recipient age difference on graft survival after heart transplant in adults with congenital heart diseaseWilliam H. Marshall, V, MD0Brent C. Lampert, DO1Curt J. Daniels, MD2Deipanjan Nandi, MD3Lydia K. Wright, MD4Department of Internal Medicine, Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio; The Heart Center, Nationwide Children’s Hospital, Columbus, Ohio; Corresponding author: William H. Marshall V, MD, Division of Cardiovascular Medicine, Davis Heart and Lung Research Institute, Wexner Medical Center at The Ohio State University, 473 W. 12th Avenue Suite 200, Columbus, OH 43210.Department of Internal Medicine, Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, OhioDepartment of Internal Medicine, Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio; The Heart Center, Nationwide Children’s Hospital, Columbus, OhioThe Heart Center, Nationwide Children’s Hospital, Columbus, OhioThe Heart Center, Nationwide Children’s Hospital, Columbus, OhioBackground: The impact of donor-recipient age difference in adult congenital heart disease (ACHD) patients undergoing heart transplant (HT) is unknown. Methods: ACHD patients (≥18 years old) who underwent HT (2000-2020) were identified using the United Network for Organ Sharing database. Graft survival through 10 years based on donor-recipient age difference was evaluated by comparing outcomes of donors >5 years older than recipients (Older), donors within 5 years of recipient age (Equal Age), and donors >5 years younger than recipients (Younger, reference group). Cox multivariable analysis was performed to evaluate the effect of donor-recipient age difference on early and late graft survival. Results: A total of 1,275 ACHD patients underwent HT (60% male, median 35 years old (interquartile range 24-46) with median graft survival of 13.7 years (95% confidence interval [CI] 11.7-16.0). Compared to Younger donors (n = 306 [24%]), graft survival was similar with Equal Age donors (n = 698 [55%]; log-rank p = 0.61), though significantly reduced with Older donors (n = 271 [21%]; log-rank p = 0.03). In multivariable analysis, late graft survival was similar with Equal Age donors but lower with Older donors (adjusted hazard ratio 1.63, 95% CI 1.16-2.28, p = 0.005), with a trend of reduced survival with Older donors in recipients <30 or ≥40 years old. Conclusions: Graft survival in ACHD patients undergoing HT was similar for those with Younger and Equal Age donors. Recipients with Older donors had reduced 10-year survival, possibly related to increased risk in those <30 and ≥40 years old. These data help inform the optimal donor age for ACHD patients requiring HT.http://www.sciencedirect.com/science/article/pii/S2950133424000843adult congenital heart diseaseheart transplantdonor agedonor selectiongraft survivalpost transplant survival |
| spellingShingle | William H. Marshall, V, MD Brent C. Lampert, DO Curt J. Daniels, MD Deipanjan Nandi, MD Lydia K. Wright, MD The impact of donor-recipient age difference on graft survival after heart transplant in adults with congenital heart disease JHLT Open adult congenital heart disease heart transplant donor age donor selection graft survival post transplant survival |
| title | The impact of donor-recipient age difference on graft survival after heart transplant in adults with congenital heart disease |
| title_full | The impact of donor-recipient age difference on graft survival after heart transplant in adults with congenital heart disease |
| title_fullStr | The impact of donor-recipient age difference on graft survival after heart transplant in adults with congenital heart disease |
| title_full_unstemmed | The impact of donor-recipient age difference on graft survival after heart transplant in adults with congenital heart disease |
| title_short | The impact of donor-recipient age difference on graft survival after heart transplant in adults with congenital heart disease |
| title_sort | impact of donor recipient age difference on graft survival after heart transplant in adults with congenital heart disease |
| topic | adult congenital heart disease heart transplant donor age donor selection graft survival post transplant survival |
| url | http://www.sciencedirect.com/science/article/pii/S2950133424000843 |
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