The effect of donor alcohol abuse on outcomes following heart transplantation. Issue 2 (24th January 2019)

• Record Type: Journal Article
• Authors: Newman, Joshua; Liebo, Max; Lowes, Brian D.; Ilias Basha, Haseeb; Peled, Yael; Cendrowski, Emily; Zolty, Ronald; Douglas, Dylan; Um, John Y.; McGee, Edwin; Heroux, Alain; Raichlin, Eugenia
• Is Part Of: Clinical transplantation. Volume 33:Issue 2(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-01-24
• Subjects: atrial fibrillation -- diastolic dysfunction -- donor characteristics -- heart transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.13461
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: 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 VCO2 > 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.