Cardiac transplantation can be safely performed with low donor-to-recipient body weight ratios

J Card Fail. 2012 Sep;18(9):688-93. doi: 10.1016/j.cardfail.2012.06.527. Epub 2012 Aug 3.

Abstract

Background: United Network for Organ Sharing adult heart transplant criteria recommend against using same-sex donors with a donor-recipient body weight ratio <0.7. The same criteria recommend against a female donor to male recipient body weight ratio <0.9. We attempted to determine if transplantation with low donor-recipient body weight ratios can be safely performed.

Methods and results: Transplants with same-sex donor-recipient body weight ratio <0.7 and female donor-male recipient body weight ratio <0.9 were compared with age- and sex-matched control subjects with ideally matched donor weights. Of the 123 patients undergoing transplantation, 23 met low donor-recipient body weight ratio criteria. This cohort was compared with 22 ideally weight-matched patients. There was no difference in survival at 1, 5, and 10 years (P = .68). Freedom from rejection (52.2 vs 50.0%; P = 1.0), creatinine clearance change (-1.3 vs 5.7 mL/min; P = .88), duration of inotropic support (191.5 vs 208.8 h; P = .65), and duration of mechanical ventilation (156.3 vs 84.5 h; P = .52) were similar. Intensive care (290.5 vs 368.6 h; P = .71) and hospital length of stay (35.4 vs 36.7 d; P = .94) were not different.

Conclusions: Accepted donor-recipient weight match criteria may be extended to increase the donor pool.

MeSH terms

  • Body Weight*
  • Female
  • Health Status Indicators
  • Heart Transplantation / adverse effects*
  • Heart Transplantation / statistics & numerical data
  • Humans
  • Kaplan-Meier Estimate
  • Length of Stay
  • Male
  • Middle Aged
  • Patient Care / statistics & numerical data*
  • Retrospective Studies
  • Safety*
  • Statistics as Topic
  • Time Factors
  • Tissue Donors
  • United States