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Article ; Online: Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death

Margo E. Hammond / Charles Zollinger / Andrija Vidic / Gregory L. Snow / Joseph Stehlik / Rami A. Alharethi / Abdallah G. Kfoury / Stavros Drakos / M Elizabeth H. Hammond

Journal of Clinical Medicine, Vol 12, Iss 24, p

2023  Volume 7629

Abstract: Background: Recent studies indicate that donor innate immune responses participate in initiating and accelerating innate responses and allorecognition in the recipient. These immune responses negatively affect recipient outcomes and predispose recipients ...

Abstract Background: Recent studies indicate that donor innate immune responses participate in initiating and accelerating innate responses and allorecognition in the recipient. These immune responses negatively affect recipient outcomes and predispose recipients to cardiovascular death (CV death). We hypothesized that a donor cause of death (COD) associated with higher levels of innate immune response would predispose recipients to more adverse outcomes post-transplant, including CV death. Methods: We performed a single-institution retrospective analysis comparing donor characteristics and COD to recipient adverse cardiovascular outcomes. We analyzed the medical records of local adult donors (age 18–64) in a database of donors where adequate data was available. Donor age was available on 706 donors; donor sex was available on 730 donors. We linked donor characteristics (age and sex) and COD to recipient CV death. The data were analyzed using logistic regression, the log-rank test of differences, and Tukey contrast. Results: Donor age, female sex, and COD of intracranial hemorrhage were significantly associated with a higher incidence of recipient CV death. Conclusions: In this single institution study, we found that recipients with hearts from donors over 40 years, donors who were female, or donors who died with a COD of intracranial hemorrhage had a higher frequency of CV death. Donor monitoring and potential treatment of innate immune activation may decrease subsequent recipient innate responses and allorecognition stimulated by donor-derived inflammatory signaling, which leads to adverse outcomes.
Keywords innate immunity ; intracranial hemorrhage ; heart transplantation ; donor factors ; antibody mediated rejection ; cardiovascular death ; Medicine ; R
Subject code 610
Language English
Publishing date 2023-12-01T00:00:00Z
Publisher MDPI AG
Document type Article ; Online
Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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