The effect of donor alcohol abuse on outcomes following heart transplantation.


Journal

Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240

Informations de publication

Date de publication:
02 2019
Historique:
received: 30 08 2018
revised: 04 11 2018
accepted: 05 12 2018
pubmed: 12 12 2018
medline: 4 4 2020
entrez: 12 12 2018
Statut: ppublish

Résumé

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. 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). 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 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.

Sections du résumé

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
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.

Identifiants

pubmed: 30536743
doi: 10.1111/ctr.13461
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13461

Informations de copyright

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Auteurs

Joshua Newman (J)

Department of Cardiology, Loyola University Medical Center, Maywood, Illinois.

Max Liebo (M)

Department of Cardiology, Loyola University Medical Center, Maywood, Illinois.

Brian D Lowes (BD)

Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska.

Haseeb Ilias Basha (H)

Department of Cardiology, Loyola University Medical Center, Maywood, Illinois.

Yael Peled (Y)

The Olga and Lev Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel.
The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Emily Cendrowski (E)

Department of Cardiology, Loyola University Medical Center, Maywood, Illinois.

Ronald Zolty (R)

Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska.

Dylan Douglas (D)

Department of Cardiology, Loyola University Medical Center, Maywood, Illinois.

John Y Um (JY)

Department of Cardiothoracic Surgery, University of Nebraska Medical Center, Omaha, Nebraska.

Edwin McGee (E)

Department of Cardiothoracic Surgery, Loyola University Medical Center, Maywood, Illinois.

Alain Heroux (A)

Department of Cardiology, Loyola University Medical Center, Maywood, Illinois.

Eugenia Raichlin (E)

Department of Cardiology, Loyola University Medical Center, Maywood, Illinois.
Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska.

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