Thorac Cardiovasc Surg
DOI: 10.1055/s-0041-1725179
Original Cardiovascular

Impact of Reported Donor Ejection Fraction on Outcome after Heart Transplantation

1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Moritz Benjamin Immohr
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Arash Mehdiani
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Philipp Rellecke
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Igor Tudorache
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
Artur Lichtenberg
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
,
1  Department of Cardiac Surgery, University Hospital, Duesseldorf, Germany
› Author Affiliations
Funding None.

Abstract

Objectives The global shortage of donor organs has urged transplanting units to extend donor selection criteria, for example, impaired left ventricular function (LVF), leading to the use of marginal donor hearts. We retrospectively analyzed our patients after orthotopic heart transplantation (oHTX) with a focus on the clinical outcome depending on donor LVF.

Methods Donor reports, intraoperative, echocardiographic, and clinical follow-up data of patients undergoing oHTX at a single-center between September 2010 and June 2020 were retrospectively analyzed. Recipients were divided into two groups based on donor left ventricular ejection fraction (dLVEF): impaired dLVEF (group I; dLVEF ≤ 50%; n = 23) and normal dLVEF group (group N; dLVEF > 50%; n = 137).

Results There was no difference in 30-day, 90-day, and 1-year survival. However, the duration of in-hospital stay was statistically longer in group I than in group N (N: 40.9 ± 28.3 days vs. I: 55.9 ± 39.4 days, p < 0.05). Furthermore, postoperative infection events were significantly more frequent in group I (p = 0.03), which was also supported by multivariate analysis (p = 0.03; odds ratio: 2.96; confidence interval: 1.12–7.83). Upon correlation analysis, dLVEF and recipient LVEF prove as statistically independent (r = 0.12, p = 0.17).

Conclusions Impaired dLVEF is associated with prolonged posttransplant recovery and slightly increased morbidity but has no significant impact on survival up to 1 year posttransplant.



Publication History

Received: 16 December 2020

Accepted: 15 January 2021

Publication Date:
16 April 2021 (online)

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