Heart failure & cardiomyopathiesCohort study

Increasing Utilization of Extended Criteria Donor Hearts for Transplantation

JACC Heart FailPublished

  • Prospective single-arm study
  • multicentre

Authors' conclusion

Use of an extracorporeal perfusion system resulted in successfully transplanting 87% of donor hearts with excellent patient survival to 2 years post-transplant and low rates of severe PGD.

Study context

Population
Adult heart transplant recipients receiving extended criteria donor (ECD) hearts from donation after brain death (DBD)ECD DBD hearts perfused
Participants
173 recipients
Outcome
Composite of 30-day survival and absence of severe primary graft dysfunction (PGD)
Follow-up
30 days

Main finding

As reported in the abstract

30-day survival free of severe PGD

Survived with no severe primary graft dysfunction (PGD) at 30 days

92%

Observational data: associations, not effects.

Secondary outcomes

Donor heart utilization rate

Perfused ECD DBD hearts successfully transplanted
150 (87%)
Did not meet study transplantation criteria
23 (13%)

30-day survival

30-day survival
97%

Severe PGD

Incidence of severe PGD
6.7%

Patient survival through 2 years · 6, 12 and 24 months

Survival at 6 months
93%
Survival at 12 months
89%
Survival at 24 months
86%
Comparable with concurrent nonrandomized controls

Safety

Heart graft-related serious adverse events within 30 days

Mean number of heart graft-related serious adverse events
0.17 (95% CI: 0.11-0.23)

Original publication

Increasing Utilization of Extended Criteria Donor Hearts for Transplantation. JACC Heart Fail. Published 24 January 2024. doi:10.1016/j.jchf.2023.11.015

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