Cardiac allograft vasculopathy and secondary outcomes at 1-year in heart transplantation from circulatory death donors

doi:10.1016/j.ahj.2026.107574

Cardiac allograft vasculopathy and secondary outcomes at 1-year in heart transplantation from circulatory death donors

Am Heart JPublished 14 Aug 2026registry analysis using unadjusted and adjusted logistic regression with propensity-score matched cohorts

Main finding · 1-year CAVResultAdjusted odds ratio 0.99 95% CI 0.77–1.28

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Authors' conclusion

One-year CAV and other key secondary clinical outcomes were similar DBD and DCD-HT recipients, irrespective of DPP or NRP procurement method. Intermediate and long-term CAV risk in DCD-HT needs to be further clarified.

Study context

Population: Adult heart transplants performed between January 2020 and June 2024 with follow-up through June 2025, with 1-year survivaleligible transplants with 1-year survival · DBD 11,393 · DCD 1,237
Participants: 12,630 participants

Exposure: One-year cardiac allograft vasculopathy (CAV) was compared between DBD and DCD recipients
DBDn = 11,393
DCDn = 1,237

Methodological detailsUNOS registry, propensity-score matched within the same heart-transplantation (HT) centers

UNOS registry
Propensity-score matched within the same HT centers

Main finding

1-year CAV · 1 year

Adjusted odds ratio

0.99

95% CI 0.77–1.28

P = 0.94

By group

DBD6.22%

DCD5.90%

DCD vs DBD

adjusted OR 0.99 (95% CI 0.77–1.28); P = 0.94

As reported in the abstract

Observational data: associations, not effects.

Secondary outcomes

Outcome	DBD	DCD	← Lower odds with DCD ←→ Higher odds with DCD →	OR (95% CI)	P value
CAV in propensity-matched pairs from the same centers · direction of ratio not stated in abstract	6.51%	5.61%	0.512	0.85 (0.60–1.21)	P = 0.37
			0.512Odds ratio (log scale)

CAV in propensity-matched pairs from the same centers: 1,106 propensity-matched pairs

Secondary outcomes (chronic dialysis, hospitalization for infection or rejection, impaired functional status)

Comparable

CAV risk by DCD procurement method (DPP and NRP)

No significant differences in CAV risk

Original publication

Cardiac allograft vasculopathy and secondary outcomes at 1-year in heart transplantation from circulatory death donors. Am Heart J. Published 14 August 2026. doi:10.1016/j.ahj.2026.107574

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Summarised from the published abstract; every number is checked against it