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VNA of Care New England

Mismatched Organ Size Tied to Worse Heart Transplant Outcome

Organ size mismatch linked to increased mortality during first year post-transplant
MONDAY, Jan. 13, 2014 (HealthDay News) -- Worsened outcomes in sex mismatch heart transplantation may be related to mismatch in organ size, according to a study published online Jan. 8 in the Journal of the American College of Cardiology: Heart Failure.
Noting that organ allocation in heart transplantation currently incorporates only body weight, Robert M. Reed, M.D., from the University of Maryland School of Medicine in Baltimore, and colleagues retrospectively analyzed 31,634 donor-recipient adult heart transplant pairings using data from the United Network for Organ Sharing transplantation registry. Predictive models were used to calculate the predicted total heart mass (pHM) for recipient and donor pairs and to assess the organ size mismatch.
The researchers found that the most-undersized pHM septile exhibited higher mortality during the first year post-transplantation (hazard ratio [HR], 1.27; P < 0.001), which remained significant after adjustment (HR, 1.25; P = 0.03). There was no variation in survival across weight difference septiles. Sex mismatch correlated with higher mortality in male patients but not female patients, in univariate analysis, but these associations were reversed after controlling for differences in pHM. Worse survival correlated with sex mismatch in female patients (one-year HR, 1.28; P = 0.02) but not in male patients (one-year HR, 1.00; P = 1.0), in adjusted analyses.
"The difference in pHM between donors and recipients of orthotopic heart transplants is a risk factor for decreased survival," the authors write.
Abstract (http://heartfailure.onlinejacc.org/article.aspx?articleid=1811669 )Full Text (subscription or payment may be required) (http://heartfailure.onlinejacc.org/article.aspx?articleid=1811669 )
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