Heart failure & cardiomyopathies
Impact of Donor Left Ventricular Geometric Remodeling and Hypertrophy on Heart Acceptance and Recipient Survival
Authors' conclusion
Classifying donor hearts using LV geometric remodeling patterns may reduce the number turned down for "hypertrophy" without compromising recipient survival.
Study context
- Population
- Brain-dead heart donors, US DHS (Donor Heart Study), February 2015 to May 20201,874 with nonacceptance surveys
- Participants
- 3,647 donors
- Exposure
- Donor left ventricular (LV) geometric remodeling patterns vs LV wall thickness >1.3 cm
- Outcome
- Prevalence of LV geometric remodeling patterns (ASE guidelines) and association with transplant acceptance and recipient mortality
- Follow-up
- 3 years
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
3-year recipient survival
Each group vs normal geometryAdjusted hazard ratio (95% CI)
Increased LV wall thickness
0.94(0.73–1.21)
Concentric remodeling
1.13(0.86–1.47)
Concentric hypertrophy
0.64(0.35–1.15)
- Concentric remodeling most common pattern
- 58.5%
Observational data: associations, not effects.
Further findings
| Outcome | Normal geometry | Concentric remodeling | Concentric hypertrophy |
|---|---|---|---|
| Reclassification of hearts with LV wall thickness >1.3 cm | — not stated in the abstract | 52.1% | 43.8% |
| LV hypertrophy listed as reason for rejection (nonacceptance surveys) | 10.8% | 60.0% | — not stated in the abstract |
— not stated in the abstract
- LV hypertrophy listed as reason for rejection (nonacceptance surveys) — LV hypertrophy listed as reason for rejection
- 20.3%
- LV hypertrophy listed as reason for rejection (nonacceptance surveys): n = 1,874 nonacceptance surveys
Original publication
Impact of Donor Left Ventricular Geometric Remodeling and Hypertrophy on Heart Acceptance and Recipient Survival. JACC Heart Fail. Published 20 May 2026. doi:10.
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