Abstract 17396: Effect of Donor Troponin on Heart Transplant Outcomes: A UNOS Registry Analysis
Introduction: Heart transplantation is the treatment of choice for end stage heart failure, but is limited to approximately 4000 globally every year due to donor shortage. Despite this, only one-third of the potential donor hearts are recovered for transplantation. Although elevated donor troponin levels have generally been considered a contraindication, the data supporting this practice is limited.
Hypothesis: Elevated donor troponins in the presence of normal left ventricular ejection fraction (LVEF) do not impact outcomes after transplantation.
Methods: All adult heart transplant recipients in the UNOS database between 2007 and 2014, with LVEF≥50%, and reported donor troponin I levels were included. The overall cohort was divided into groups based on clinically meaningful troponin I levels: below 1, 1-10, 10.1-20 and above 20 and compared for recipient survival and coronary allograft vasculopathy (CAV).
Results:11,640 transplants met the study criteria. On comparison of baseline characteristics, higher troponin groups had younger donors and greater donor CPR. Importantly, the ischemic time and proportion of recipients in the ICU and on temporary circulatory support were similar. As shown, there was no difference in survival (figure 1) or CAV (figure 2) up to 5 years of follow up using Kaplan-Meir analysis and cox-hazards ratio. After adjusting for differences in baseline covariates and clinically relevant factors, the findings remained unchanged.
Conclusions: In this largest analysis to date, elevated donor troponin levels in the setting of preserved LVEF did not impact recipient survival or CAV up to 5 years of follow up. This finding can help expand the donor pool.
Author Disclosures: S.A. Madan: None. O. Saeed: None. D. Sims: None. J.J. Shin: None. I. Pina: None. D. D'Alessandro: None. D. Goldstein: Consultant/Advisory Board; Modest; Heartware Inc, Medtronic Inc. Other; Modest; Thoratec Inc, SunshineHeart Inc. U. Jorde: None. S.R. Patel: None.
- © 2015 by American Heart Association, Inc.