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Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database: Analysis of the United Network for Or...
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| Zeitschriftentitel: | Circulation |
|---|---|
| Personen und Körperschaften: | , , , , , , |
| In: | Circulation, 118, 2008, 14_suppl_1 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Ovid Technologies (Wolters Kluwer Health)
|
| Schlagwörter: |
| author_facet |
Patel, Nishant D. Weiss, Eric S. Nwakanma, Lois U. Russell, Stuart D. Baumgartner, William A. Shah, Ashish S. Conte, John V. Patel, Nishant D. Weiss, Eric S. Nwakanma, Lois U. Russell, Stuart D. Baumgartner, William A. Shah, Ashish S. Conte, John V. |
|---|---|
| author |
Patel, Nishant D. Weiss, Eric S. Nwakanma, Lois U. Russell, Stuart D. Baumgartner, William A. Shah, Ashish S. Conte, John V. |
| spellingShingle |
Patel, Nishant D. Weiss, Eric S. Nwakanma, Lois U. Russell, Stuart D. Baumgartner, William A. Shah, Ashish S. Conte, John V. Circulation Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database Physiology (medical) Cardiology and Cardiovascular Medicine |
| author_sort |
patel, nishant d. |
| spelling |
Patel, Nishant D. Weiss, Eric S. Nwakanma, Lois U. Russell, Stuart D. Baumgartner, William A. Shah, Ashish S. Conte, John V. 0009-7322 1524-4539 Ovid Technologies (Wolters Kluwer Health) Physiology (medical) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/circulationaha.107.756866 <jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> Generally accepted donor criteria for heart transplantation limit allografts from donors within approximately 20% to 30% of the recipient’s weight. We analyzed the impact of donor-to-recipient weight ratio on survival after heart transplantation. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> Adult heart transplant recipients reported to the United Network for Organ Sharing from 1999 to 2007 were divided into 3 groups based on donor-to-recipient weight ratio: <0.8, 0.8 to 1.2, and >1.2. Kaplan-Meier methodology was used to estimate survival. Propensity-adjusted Cox regression modeling was used to analyze predictors of mortality. A total of 15 284 heart transplant recipients were analyzed; 2078 had weight ratio of <0.8, 9684 had 0.8 to 1.2, and 3522 had >1.2. Kaplan-Meier survival was not statistically different between groups at 5 years ( <jats:italic>P</jats:italic> =0.26). Among patients with weight ratio <0.8, 5-year survival was lower for recipients with high pulmonary vascular resistance (>4 Woods units; <jats:italic>P</jats:italic> =0.02). Among recipients with high pulmonary vascular resistance, 5-year survival was similar for those with weight ratio 0.8 to 1.2 and >1.2 ( <jats:italic>P</jats:italic> =0.44) <jats:italic>.</jats:italic> Furthermore, male recipients with elevated pulmonary vascular resistance who received hearts from female donors had a significantly worse survival than males who received hearts from male donors ( <jats:italic>P</jats:italic> =0.01). Propensity-adjusted multivariable analysis demonstrated that weight ratio <0.8 did not predict mortality (hazard ratio, 1.09; 95% CI, 0.94 to 1.27; <jats:italic>P</jats:italic> =0.21). Five-year survival after propensity matching was not statistically different between those with weight ratio <0.8 versus ≥0.8 ( <jats:italic>P</jats:italic> =0.37). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Weight ratio did not predict mortality after heart transplantation. However, recipients with elevated pulmonary vascular resistance who received undersized hearts had poor survival. Furthermore, in the setting of high pulmonary vascular resistance, male recipients who received hearts from female donors had worse survival than those who received hearts from male donors. Extending donor criteria to include undersized hearts in select recipients should be considered. </jats:p> Analysis of the United Network for Organ Sharing Database Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database Circulation |
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10.1161/circulationaha.107.756866 |
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Ovid Technologies (Wolters Kluwer Health), 2008 |
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Ovid Technologies (Wolters Kluwer Health), 2008 |
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0009-7322 1524-4539 |
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Ovid Technologies (Wolters Kluwer Health) |
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ai |
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Circulation |
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49 |
| title_sub |
Analysis of the United Network for Organ Sharing Database |
| title |
Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_unstemmed |
Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_full |
Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_fullStr |
Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_full_unstemmed |
Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_short |
Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_sort |
impact of donor-to-recipient weight ratio on survival after heart transplantation : analysis of the united network for organ sharing database |
| topic |
Physiology (medical) Cardiology and Cardiovascular Medicine |
| url |
http://dx.doi.org/10.1161/circulationaha.107.756866 |
| publishDate |
2008 |
| physical |
|
| description |
<jats:p>
<jats:bold>
<jats:italic>Background—</jats:italic>
</jats:bold>
Generally accepted donor criteria for heart transplantation limit allografts from donors within approximately 20% to 30% of the recipient’s weight. We analyzed the impact of donor-to-recipient weight ratio on survival after heart transplantation.
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Methods and Results—</jats:italic>
</jats:bold>
Adult heart transplant recipients reported to the United Network for Organ Sharing from 1999 to 2007 were divided into 3 groups based on donor-to-recipient weight ratio: <0.8, 0.8 to 1.2, and >1.2. Kaplan-Meier methodology was used to estimate survival. Propensity-adjusted Cox regression modeling was used to analyze predictors of mortality. A total of 15 284 heart transplant recipients were analyzed; 2078 had weight ratio of <0.8, 9684 had 0.8 to 1.2, and 3522 had >1.2. Kaplan-Meier survival was not statistically different between groups at 5 years (
<jats:italic>P</jats:italic>
=0.26). Among patients with weight ratio <0.8, 5-year survival was lower for recipients with high pulmonary vascular resistance (>4 Woods units;
<jats:italic>P</jats:italic>
=0.02). Among recipients with high pulmonary vascular resistance, 5-year survival was similar for those with weight ratio 0.8 to 1.2 and >1.2 (
<jats:italic>P</jats:italic>
=0.44)
<jats:italic>.</jats:italic>
Furthermore, male recipients with elevated pulmonary vascular resistance who received hearts from female donors had a significantly worse survival than males who received hearts from male donors (
<jats:italic>P</jats:italic>
=0.01). Propensity-adjusted multivariable analysis demonstrated that weight ratio <0.8 did not predict mortality (hazard ratio, 1.09; 95% CI, 0.94 to 1.27;
<jats:italic>P</jats:italic>
=0.21). Five-year survival after propensity matching was not statistically different between those with weight ratio <0.8 versus ≥0.8 (
<jats:italic>P</jats:italic>
=0.37).
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Conclusions—</jats:italic>
</jats:bold>
Weight ratio did not predict mortality after heart transplantation. However, recipients with elevated pulmonary vascular resistance who received undersized hearts had poor survival. Furthermore, in the setting of high pulmonary vascular resistance, male recipients who received hearts from female donors had worse survival than those who received hearts from male donors. Extending donor criteria to include undersized hearts in select recipients should be considered.
</jats:p> |
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| author | Patel, Nishant D., Weiss, Eric S., Nwakanma, Lois U., Russell, Stuart D., Baumgartner, William A., Shah, Ashish S., Conte, John V. |
| author_facet | Patel, Nishant D., Weiss, Eric S., Nwakanma, Lois U., Russell, Stuart D., Baumgartner, William A., Shah, Ashish S., Conte, John V., Patel, Nishant D., Weiss, Eric S., Nwakanma, Lois U., Russell, Stuart D., Baumgartner, William A., Shah, Ashish S., Conte, John V. |
| author_sort | patel, nishant d. |
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| description | <jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> Generally accepted donor criteria for heart transplantation limit allografts from donors within approximately 20% to 30% of the recipient’s weight. We analyzed the impact of donor-to-recipient weight ratio on survival after heart transplantation. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> Adult heart transplant recipients reported to the United Network for Organ Sharing from 1999 to 2007 were divided into 3 groups based on donor-to-recipient weight ratio: <0.8, 0.8 to 1.2, and >1.2. Kaplan-Meier methodology was used to estimate survival. Propensity-adjusted Cox regression modeling was used to analyze predictors of mortality. A total of 15 284 heart transplant recipients were analyzed; 2078 had weight ratio of <0.8, 9684 had 0.8 to 1.2, and 3522 had >1.2. Kaplan-Meier survival was not statistically different between groups at 5 years ( <jats:italic>P</jats:italic> =0.26). Among patients with weight ratio <0.8, 5-year survival was lower for recipients with high pulmonary vascular resistance (>4 Woods units; <jats:italic>P</jats:italic> =0.02). Among recipients with high pulmonary vascular resistance, 5-year survival was similar for those with weight ratio 0.8 to 1.2 and >1.2 ( <jats:italic>P</jats:italic> =0.44) <jats:italic>.</jats:italic> Furthermore, male recipients with elevated pulmonary vascular resistance who received hearts from female donors had a significantly worse survival than males who received hearts from male donors ( <jats:italic>P</jats:italic> =0.01). Propensity-adjusted multivariable analysis demonstrated that weight ratio <0.8 did not predict mortality (hazard ratio, 1.09; 95% CI, 0.94 to 1.27; <jats:italic>P</jats:italic> =0.21). Five-year survival after propensity matching was not statistically different between those with weight ratio <0.8 versus ≥0.8 ( <jats:italic>P</jats:italic> =0.37). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Weight ratio did not predict mortality after heart transplantation. However, recipients with elevated pulmonary vascular resistance who received undersized hearts had poor survival. Furthermore, in the setting of high pulmonary vascular resistance, male recipients who received hearts from female donors had worse survival than those who received hearts from male donors. Extending donor criteria to include undersized hearts in select recipients should be considered. </jats:p> |
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| spelling | Patel, Nishant D. Weiss, Eric S. Nwakanma, Lois U. Russell, Stuart D. Baumgartner, William A. Shah, Ashish S. Conte, John V. 0009-7322 1524-4539 Ovid Technologies (Wolters Kluwer Health) Physiology (medical) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/circulationaha.107.756866 <jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> Generally accepted donor criteria for heart transplantation limit allografts from donors within approximately 20% to 30% of the recipient’s weight. We analyzed the impact of donor-to-recipient weight ratio on survival after heart transplantation. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> Adult heart transplant recipients reported to the United Network for Organ Sharing from 1999 to 2007 were divided into 3 groups based on donor-to-recipient weight ratio: <0.8, 0.8 to 1.2, and >1.2. Kaplan-Meier methodology was used to estimate survival. Propensity-adjusted Cox regression modeling was used to analyze predictors of mortality. A total of 15 284 heart transplant recipients were analyzed; 2078 had weight ratio of <0.8, 9684 had 0.8 to 1.2, and 3522 had >1.2. Kaplan-Meier survival was not statistically different between groups at 5 years ( <jats:italic>P</jats:italic> =0.26). Among patients with weight ratio <0.8, 5-year survival was lower for recipients with high pulmonary vascular resistance (>4 Woods units; <jats:italic>P</jats:italic> =0.02). Among recipients with high pulmonary vascular resistance, 5-year survival was similar for those with weight ratio 0.8 to 1.2 and >1.2 ( <jats:italic>P</jats:italic> =0.44) <jats:italic>.</jats:italic> Furthermore, male recipients with elevated pulmonary vascular resistance who received hearts from female donors had a significantly worse survival than males who received hearts from male donors ( <jats:italic>P</jats:italic> =0.01). Propensity-adjusted multivariable analysis demonstrated that weight ratio <0.8 did not predict mortality (hazard ratio, 1.09; 95% CI, 0.94 to 1.27; <jats:italic>P</jats:italic> =0.21). Five-year survival after propensity matching was not statistically different between those with weight ratio <0.8 versus ≥0.8 ( <jats:italic>P</jats:italic> =0.37). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Weight ratio did not predict mortality after heart transplantation. However, recipients with elevated pulmonary vascular resistance who received undersized hearts had poor survival. Furthermore, in the setting of high pulmonary vascular resistance, male recipients who received hearts from female donors had worse survival than those who received hearts from male donors. Extending donor criteria to include undersized hearts in select recipients should be considered. </jats:p> Analysis of the United Network for Organ Sharing Database Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database Circulation |
| spellingShingle | Patel, Nishant D., Weiss, Eric S., Nwakanma, Lois U., Russell, Stuart D., Baumgartner, William A., Shah, Ashish S., Conte, John V., Circulation, Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database, Physiology (medical), Cardiology and Cardiovascular Medicine |
| title | Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_full | Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_fullStr | Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_full_unstemmed | Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_short | Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| title_sort | impact of donor-to-recipient weight ratio on survival after heart transplantation : analysis of the united network for organ sharing database |
| title_sub | Analysis of the United Network for Organ Sharing Database |
| title_unstemmed | Impact of Donor-to-Recipient Weight Ratio on Survival After Heart Transplantation : Analysis of the United Network for Organ Sharing Database |
| topic | Physiology (medical), Cardiology and Cardiovascular Medicine |
| url | http://dx.doi.org/10.1161/circulationaha.107.756866 |