Hammond, M.E.; Zollinger, C.; Vidic, A.; Snow, G.L.; Stehlik, J.; Alharethi, R.A.; Kfoury, A.G.; Drakos, S.; Hammond, M.E.H. Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death. J. Clin. Med.2023, 12, 7629.
Hammond, M.E.; Zollinger, C.; Vidic, A.; Snow, G.L.; Stehlik, J.; Alharethi, R.A.; Kfoury, A.G.; Drakos, S.; Hammond, M.E.H. Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death. J. Clin. Med. 2023, 12, 7629.
Hammond, M.E.; Zollinger, C.; Vidic, A.; Snow, G.L.; Stehlik, J.; Alharethi, R.A.; Kfoury, A.G.; Drakos, S.; Hammond, M.E.H. Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death. J. Clin. Med.2023, 12, 7629.
Hammond, M.E.; Zollinger, C.; Vidic, A.; Snow, G.L.; Stehlik, J.; Alharethi, R.A.; Kfoury, A.G.; Drakos, S.; Hammond, M.E.H. Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death. J. Clin. Med. 2023, 12, 7629.
Abstract
Background
Recent studies indicate that donor innate immune responses participate in initiating and accelerating innate responses and allorecognition in the recipient. These immune responses negatively affect recipient outcomes and predispose recipients to allograft coronary artery vasculopathy (CAV). We hypothesized that donor cause of death (COD) associated with higher levels of innate immune response would predispose recipients to more adverse outcomes post-transplant, including CAV.
Methods
We performed a single-institution retrospective analysis comparing donor characteristics and COD to recipient adverse cardiovascular outcomes. We analyzed the medical records of local adult donors (age 18-64) in a database of donors where adequate data was available. We linked donor characteristics and COD to recipient adverse cardiac outcomes after transplant, including cardiovascular (CV) death and incidence of significant antibody-mediated rejection (pAMR) after transplant (>2 episodes of pAMR within 90 days post-transplant). The data were analyzed using logistic regression, log-rank test of differences, and Tukey Contrast.
Results
Donor advanced age, female sex, and CODs of motor vehicle accident and intracranial hemorrhage were significantly associated with a higher incidence of recipient CV death and early pAMR compared to other donor characteristics and CODs.
Conclusions
In this single institution study, we found that recipients with hearts from donors over 40 years, donors who were female, or donors who died with a COD of motor vehicle accidents or intracranial hemorrhage had a higher frequency of CV related deaths and early pAMR. Donor monitoring and potential treatment of innate immune activation may decrease subsequent recipient innate responses and allorecognition stimulated by donor derived inflammatory signaling which lead to adverse outcomes.
Biology and Life Sciences, Biochemistry and Molecular Biology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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