Selective Angiography of Stimulant-Exposed Cardiac Donors Following Circulatory Death Does Not Impact Post-Transplant Outcomes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Data Source, and Study Population
2.2. Inclusion and Exclusion Criteria
2.3. Data Collection and Variable Selection
2.4. Statistical Analyses
3. Results
3.1. Donor and Recipient Demographics and Clinical Characteristics
3.2. Post-Transplant Outcomes
3.3. Cox Regression Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CAD | Coronary Artery Disease |
CVA | Cerebrovascular Accident |
DBD | Donation after Brain Death |
DCD | Donation after Circulatory Death |
ECMO | Extracorporeal Membrane Oxygenation |
HR | Hazard Ratio |
IABP | Intra-Aortic Balloon Pump |
IQR | Interquartile Range |
ISHLT | International Society for Heart and Lung Transplantation |
LHC | Left Heart Catheterization |
MI | Myocardial Infarction |
OPTN | Organ Procurement and Transplantation Network |
UNOS | United Network for Organ Sharing |
References
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Variable Stratified Variable | LHC (n = 135) | Non-LHC (n = 350) | Total (n = 485) | p-Value |
---|---|---|---|---|
Recipient | ||||
Age (years) | 54 ± 11 | 54 ± 12 | 54 ± 12 | 0.70 |
Sex | ||||
Male | 106 (79%) | 294 (84%) | 400 (83%) | 0.20 |
Female | 29 (21%) | 56 (16%) | 85 (17%) | - |
Race/Ethnicity | ||||
White | 93 (69%) | 227 (65%) | 320 (66%) | 0.47 |
Black | 19 (14%) | 70 (20%) | 89 (18%) | - |
Hispanic | 20 (15%) | 42 (12%) | 62 (13%) | - |
Insurance Type | ||||
Private | 70 (52%) | 162 (46%) | 204 (45%) | 0.46 |
Medicare/Medicaid | 62 (46%) | 183 (52%) | 245 (50%) | - |
Self-Pay | - | - | - | - |
Education Level | ||||
High school or less | 48 (36%) | 133 (38%) | 181 (37%) | 0.29 |
College or beyond | 77 (57%) | 203 (58%) | 280 (58%) | - |
Employed | ||||
Yes | 22 (16%) | 76 (22%) | 98 (20%) | 0.30 |
Body Mass Index (kg/m2) | 28 ± 5 | 28 ± 5 | 28 ± 5 | 0.50 |
Diabetes | 41 (30%) | 113 (32%) | 154 (32%) | 0.64 |
Cerebrovascular Disease | 6 (5%) | 34 (10%) | 40 (9%) | 0.07 |
Dialysis | 2 (1%) | 7 (2%) | 9 (2%) | 0.77 |
Cancer | 12 (9%) | 33 (9%) | 45 (9%) | 0.89 |
Smoking History | 56 (41%) | 166 (47%) | 222 (46%) | 0.32 |
Life Support | ||||
ECMO | 3 (2%) | 8 (2%) | 11 (2%) | 0.83 |
IABP | 18 (13%) | 54 (15%) | 72 (15%) | 0.57 |
Mechanical Ventilator | 2 (1%) | 4 (1%) | 6 (1%) | 0.83 |
Variable Stratified Variable | LHC (n = 135) | Non-LHC (n = 350) | Total (n = 485) | p-Value |
---|---|---|---|---|
Donor | ||||
Age (years) | 39 ± 6 | 31 ± 7 | 33 ± 8 | <0.001 |
Sex | ||||
Male | 112 (83%) | 302 (86%) | 414 (85%) | 0.43 |
Female | 23 (17%) | 48 (14%) | 71 (15%) | - |
Race/Ethnicity | ||||
White | 107 (79%) | 265 (76%) | 372 (77%) | 0.89 |
Black | 8 (6%) | 27 (8%) | 35 (7%) | - |
Hispanic | 16 (12%) | 49 (14%) | 65 (13%) | - |
Body Mass Index (kg/m2) | 29 ± 7 | 28 ± 6 | 28 ± 6 | 0.05 |
Diabetes | 11 (8%) | 11 (3%) | 22 (5%) | 0.02 |
Hypertension | 28 (21%) | 43 (12%) | 71 (14%) | 0.02 |
Myocardial Infarction | 4 (3%) | 3 (1%) | 7 (1%) | 0.08 |
Smoking History | 49 (37%) | 57 (17%) | 106 (22%) | <0.001 |
Heavy Alcohol Use | 61 (47%) | 124 (37%) | 185 (40%) | 0.06 |
Cocaine Use History | 55 (41%) | 200 (57%) | 255 (52%) | 0.001 |
Amphetamine Use History | 54 (40%) | 95 (27%) | 149 (31%) | 0.001 |
Variable Stratified Variable | LHC (n = 135) | Non-LHC (n = 350) | Total (n = 485) | p-Value |
---|---|---|---|---|
Match Run | ||||
Waitlist Time (Days) | 22 [9, 167] | 26 [8, 135] | 25 [8, 147] | 0.44 |
cPRA | 21 ± 31 | 16 ± 24 | 18 ± 27 | 0.32 |
HLA Mismatch | 5 [4, 5] | 5 [4, 5] | 5 [4, 5] | 0.29 |
Sex Mismatch | 20 (15%) | 54 (15%) | 74 (15%) | 0.88 |
Ischemic Time (minutes) | 309 [183, 381] | 306 [217, 382] | 307 [214, 382] | 0.79 |
Outcomes | ||||
Renal Replacement | 27 (20%) | 54 (15%) | 81 (17%) | 0.22 |
Cerebrovascular Accident | 6 (4%) | 13 (4%) | 19 (4%) | 0.71 |
ECMO | 2 (1%) | 11 (3%) | 13 (3%) | 0.31 |
Acute Cellular Rejection | 14 (10%) | 40 (11%) | 54 (11%) | 0.75 |
Treated for Rejection | 3 (2%) | 25 (7%) | 28 (6%) | 0.04 |
Length of Stay | 16 [13, 27] | 16 [12, 23] | 16 [12, 24] | 0.93 |
Variable Stratified Variable | LHC (n = 135) | Non-LHC (n = 350) | Total (n = 485) | p-Value |
---|---|---|---|---|
Graft Failure | ||||
30-day Graft Failure | 9 (7%) | 11 (3%) | 20 (4%) | 0.08 |
90-day Graft Failure | 9 (7%) | 13 (4%) | 22 (5%) | 0.16 |
1-year Graft Failure | 10 (7%) | 21 (6%) | 31 (6%) | 0.57 |
Recipient Mortality | ||||
30-day Mortality | 8 (6%) | 10 (3%) | 18 (4%) | 0.11 |
90-day Mortality | 8 (6%) | 12 (3%) | 20 (4%) | 0.21 |
1-year Mortality | 10 (7%) | 20 (6%) | 30 (6%) | 0.48 |
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Rust, C.J.; Reul, R.M., Jr.; Abadiotakis, H.; Kodimerla, R.; Preston, J.D.; Randhawa, S.S.; Halkos, M.E.; Bishawi, M.M.; Daneshmand, M.A.; Chan, J.L. Selective Angiography of Stimulant-Exposed Cardiac Donors Following Circulatory Death Does Not Impact Post-Transplant Outcomes. J. Clin. Med. 2025, 14, 3809. https://doi.org/10.3390/jcm14113809
Rust CJ, Reul RM Jr., Abadiotakis H, Kodimerla R, Preston JD, Randhawa SS, Halkos ME, Bishawi MM, Daneshmand MA, Chan JL. Selective Angiography of Stimulant-Exposed Cardiac Donors Following Circulatory Death Does Not Impact Post-Transplant Outcomes. Journal of Clinical Medicine. 2025; 14(11):3809. https://doi.org/10.3390/jcm14113809
Chicago/Turabian StyleRust, Clayton J., Ross Michael Reul, Jr., Helen Abadiotakis, Reshma Kodimerla, Joshua D. Preston, Supreet S. Randhawa, Michael E. Halkos, Muath M. Bishawi, Mani A. Daneshmand, and Joshua L. Chan. 2025. "Selective Angiography of Stimulant-Exposed Cardiac Donors Following Circulatory Death Does Not Impact Post-Transplant Outcomes" Journal of Clinical Medicine 14, no. 11: 3809. https://doi.org/10.3390/jcm14113809
APA StyleRust, C. J., Reul, R. M., Jr., Abadiotakis, H., Kodimerla, R., Preston, J. D., Randhawa, S. S., Halkos, M. E., Bishawi, M. M., Daneshmand, M. A., & Chan, J. L. (2025). Selective Angiography of Stimulant-Exposed Cardiac Donors Following Circulatory Death Does Not Impact Post-Transplant Outcomes. Journal of Clinical Medicine, 14(11), 3809. https://doi.org/10.3390/jcm14113809