tetano
Editor, Senior Moderator
J Am Heart Assoc
. 2023 Jul 8;e029178.
doi: 10.1161/JAHA.122.029178. Online ahead of print. Outcomes of COVID-19-Positive Donor Heart Transplantation in the United States
Samuel T Kim[SUP] 1 [/SUP], Amit Iyengar[SUP] 2 [/SUP], Mark R Helmers[SUP] 2 [/SUP], Noah Weingarten[SUP] 2 [/SUP], David Rekhtman[SUP] 2 [/SUP], Cindy Song[SUP] 2 [/SUP], Max Shin[SUP] 2 [/SUP], Marisa Cevasco[SUP] 2 [/SUP], Pavan Atluri[SUP] 2 [/SUP]
Affiliations
Background Little is known regarding the impact of donor COVID-19 status on recipient outcomes after heart transplantation. In this study, we characterize outcomes of the first 110 heart transplants from organ donors positive for COVID-19 (COVID-19+) in the United States. Methods and Results Retrospective analysis of the United Network for Organ Sharing database was performed for single-organ adult heart transplants from January 2020 to March 2022. Donor COVID-19+ status was defined as a positive nucleic acid amplification, antigen, or other COVID-19 test within 7 days of transplant. Nearest-neighbor propensity score matching used to adjust for differences between recipients of COVID-19+ and nonpositive donor hearts. Overall, 7251 heart transplants were included in analysis, with 110 using COVID-19+ donor hearts. Recipients of COVID-19+ allografts were younger (54 [interquartile range, 41-61]) versus 57 [46-64] years; P=0.02) but had similar rates of female sex and non-White race compared with those receiving allografts from negative donors. Nearest-neighbor propensity score matching resulted in 100 well-matched pairs of recipients of COVID-19+ versus nonpositive donor organs. The 2 matched groups had similar median lengths of stay (15 [11-23] days versus 15 [13-23] days; P=0.40), rates of graft failure (1% versus 0%; P=0.99), 30-day death (3% versus 3%; P=0.99), and 3-month survival (88% versus 94%; P=0.23) compared with recipients of nonpositive donors. No deaths occurred due to COVID-19 infection among the 8 (7%) total deceased recipients of COVID-19+ allografts to date. Conclusions Short-term outcomes of heart transplant recipients receiving COVID-19+ donor organs are reassuring. However, continued monitoring for long-term survival and potential complications are warranted.
Keywords: coronavirus disease 2019; donor qualities; heart failure; heart transplantation; outcomes research; survival.
. 2023 Jul 8;e029178.
doi: 10.1161/JAHA.122.029178. Online ahead of print. Outcomes of COVID-19-Positive Donor Heart Transplantation in the United States
Samuel T Kim[SUP] 1 [/SUP], Amit Iyengar[SUP] 2 [/SUP], Mark R Helmers[SUP] 2 [/SUP], Noah Weingarten[SUP] 2 [/SUP], David Rekhtman[SUP] 2 [/SUP], Cindy Song[SUP] 2 [/SUP], Max Shin[SUP] 2 [/SUP], Marisa Cevasco[SUP] 2 [/SUP], Pavan Atluri[SUP] 2 [/SUP]
Affiliations
- PMID: 37421286
- DOI: 10.1161/JAHA.122.029178
Background Little is known regarding the impact of donor COVID-19 status on recipient outcomes after heart transplantation. In this study, we characterize outcomes of the first 110 heart transplants from organ donors positive for COVID-19 (COVID-19+) in the United States. Methods and Results Retrospective analysis of the United Network for Organ Sharing database was performed for single-organ adult heart transplants from January 2020 to March 2022. Donor COVID-19+ status was defined as a positive nucleic acid amplification, antigen, or other COVID-19 test within 7 days of transplant. Nearest-neighbor propensity score matching used to adjust for differences between recipients of COVID-19+ and nonpositive donor hearts. Overall, 7251 heart transplants were included in analysis, with 110 using COVID-19+ donor hearts. Recipients of COVID-19+ allografts were younger (54 [interquartile range, 41-61]) versus 57 [46-64] years; P=0.02) but had similar rates of female sex and non-White race compared with those receiving allografts from negative donors. Nearest-neighbor propensity score matching resulted in 100 well-matched pairs of recipients of COVID-19+ versus nonpositive donor organs. The 2 matched groups had similar median lengths of stay (15 [11-23] days versus 15 [13-23] days; P=0.40), rates of graft failure (1% versus 0%; P=0.99), 30-day death (3% versus 3%; P=0.99), and 3-month survival (88% versus 94%; P=0.23) compared with recipients of nonpositive donors. No deaths occurred due to COVID-19 infection among the 8 (7%) total deceased recipients of COVID-19+ allografts to date. Conclusions Short-term outcomes of heart transplant recipients receiving COVID-19+ donor organs are reassuring. However, continued monitoring for long-term survival and potential complications are warranted.
Keywords: coronavirus disease 2019; donor qualities; heart failure; heart transplantation; outcomes research; survival.