Association between increased-risk donor social behaviors and recipient outcomes after heart transplantation
Alexis K. Okoh, Olivia Chan, Molly Schultheis, Mitalie Gupta, Aakash Shah, Justin Gold, Mark J. Russo, Leonard Y. Lee, Margarita Camacho
Robert Wood Johnson Medical School (RWJMS), Surgery-Chairman-Meb
Robert Wood Johnson Medical School (RWJMS), Surgery
Background: This study aims to investigate the association between social behaviors of increased-risk donors (IRD) and recipient outcomes after heart transplantation. Methods: The United Network for Organ Sharing (UNOS) database was queried to identify patients who received a heart transplant between 2004 and 2015. Patients were grouped based on donor's risk status (IRD vs standard risk donor [SRD]). Recipients of IRD were categorized based on donor social behaviors (SB), and recipient survival was assessed. Cox regression analysis was used to identify associations between SB of donors and recipient survival. Results: Out of 22 333 heart transplantations performed during the study period, 2769 (12%) received an IRD graft with the following SB: Unprofessional tattoos or piercings (n = 1722) (63%), cocaine use (n = 916) (33%), heavy smoking (n = 437) (16%), and heavy alcohol abuse (n = 610) (22%). Viral screens detected 72(3%) hepatitis B virus (HBV) positive and 12 (0.4%) hepatitis C virus (HCV) positive at donation. There was no difference in recipient survival based on both donor risk and their social behaviors. Cox regression analysis found only donor HCV infection and non-identical ABO mismatch to be associated with poor recipient survival among recipients of IR grafts. Conclusion: Cardiac allografts from IRD, serologically negative for viruses, can safely be used. There is no association between social behaviors of IRD and recipient survival.
Clinical Transplantation
https://doi.org/10.1111/ctr.13787
increased-risk donor
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Social Behavior Medicine & Life Sciences 100%
Heart Transplantation Medicine & Life Sciences 90%
Tissue Donors Medicine & Life Sciences 67%
Transplants Medicine & Life Sciences 13%
Hepacivirus Medicine & Life Sciences 13%
Tattooing Medicine & Life Sciences 9%
Regression Analysis Medicine & Life Sciences 9%
Okoh, A. K., Chan, O., Schultheis, M., Gupta, M., Shah, A., Gold, J., Russo, M. J., Lee, L. Y., & Camacho, M. (2020). Association between increased-risk donor social behaviors and recipient outcomes after heart transplantation. Clinical Transplantation, 34(3), [e13787]. https://doi.org/10.1111/ctr.13787
Okoh, Alexis K. ; Chan, Olivia ; Schultheis, Molly et al. / Association between increased-risk donor social behaviors and recipient outcomes after heart transplantation. In: Clinical Transplantation. 2020 ; Vol. 34, No. 3.
@article{b0ac78f72f414b999ed9d29bd4b03c31,
title = "Association between increased-risk donor social behaviors and recipient outcomes after heart transplantation",
abstract = "Background: This study aims to investigate the association between social behaviors of increased-risk donors (IRD) and recipient outcomes after heart transplantation. Methods: The United Network for Organ Sharing (UNOS) database was queried to identify patients who received a heart transplant between 2004 and 2015. Patients were grouped based on donor's risk status (IRD vs standard risk donor [SRD]). Recipients of IRD were categorized based on donor social behaviors (SB), and recipient survival was assessed. Cox regression analysis was used to identify associations between SB of donors and recipient survival. Results: Out of 22 333 heart transplantations performed during the study period, 2769 (12%) received an IRD graft with the following SB: Unprofessional tattoos or piercings (n = 1722) (63%), cocaine use (n = 916) (33%), heavy smoking (n = 437) (16%), and heavy alcohol abuse (n = 610) (22%). Viral screens detected 72(3%) hepatitis B virus (HBV) positive and 12 (0.4%) hepatitis C virus (HCV) positive at donation. There was no difference in recipient survival based on both donor risk and their social behaviors. Cox regression analysis found only donor HCV infection and non-identical ABO mismatch to be associated with poor recipient survival among recipients of IR grafts. Conclusion: Cardiac allografts from IRD, serologically negative for viruses, can safely be used. There is no association between social behaviors of IRD and recipient survival.",
keywords = "heart failure, heart transplant, hepatitis, increased-risk donor",
author = "Okoh, {Alexis K.} and Olivia Chan and Molly Schultheis and Mitalie Gupta and Aakash Shah and Justin Gold and Russo, {Mark J.} and Lee, {Leonard Y.} and Margarita Camacho",
note = "Publisher Copyright: {\textcopyright} 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
doi = "https://doi.org/10.1111/ctr.13787",
journal = "Clinical Transplantation",
Okoh, AK, Chan, O, Schultheis, M, Gupta, M, Shah, A, Gold, J, Russo, MJ, Lee, LY & Camacho, M 2020, 'Association between increased-risk donor social behaviors and recipient outcomes after heart transplantation', Clinical Transplantation, vol. 34, no. 3, e13787. https://doi.org/10.1111/ctr.13787
Association between increased-risk donor social behaviors and recipient outcomes after heart transplantation. / Okoh, Alexis K.; Chan, Olivia; Schultheis, Molly et al.
In: Clinical Transplantation, Vol. 34, No. 3, e13787, 01.03.2020.
T1 - Association between increased-risk donor social behaviors and recipient outcomes after heart transplantation
AU - Okoh, Alexis K.
AU - Chan, Olivia
AU - Schultheis, Molly
AU - Gupta, Mitalie
AU - Shah, Aakash
AU - Gold, Justin
AU - Russo, Mark J.
AU - Lee, Leonard Y.
AU - Camacho, Margarita
N1 - Publisher Copyright: © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
N2 - Background: This study aims to investigate the association between social behaviors of increased-risk donors (IRD) and recipient outcomes after heart transplantation. Methods: The United Network for Organ Sharing (UNOS) database was queried to identify patients who received a heart transplant between 2004 and 2015. Patients were grouped based on donor's risk status (IRD vs standard risk donor [SRD]). Recipients of IRD were categorized based on donor social behaviors (SB), and recipient survival was assessed. Cox regression analysis was used to identify associations between SB of donors and recipient survival. Results: Out of 22 333 heart transplantations performed during the study period, 2769 (12%) received an IRD graft with the following SB: Unprofessional tattoos or piercings (n = 1722) (63%), cocaine use (n = 916) (33%), heavy smoking (n = 437) (16%), and heavy alcohol abuse (n = 610) (22%). Viral screens detected 72(3%) hepatitis B virus (HBV) positive and 12 (0.4%) hepatitis C virus (HCV) positive at donation. There was no difference in recipient survival based on both donor risk and their social behaviors. Cox regression analysis found only donor HCV infection and non-identical ABO mismatch to be associated with poor recipient survival among recipients of IR grafts. Conclusion: Cardiac allografts from IRD, serologically negative for viruses, can safely be used. There is no association between social behaviors of IRD and recipient survival.
AB - Background: This study aims to investigate the association between social behaviors of increased-risk donors (IRD) and recipient outcomes after heart transplantation. Methods: The United Network for Organ Sharing (UNOS) database was queried to identify patients who received a heart transplant between 2004 and 2015. Patients were grouped based on donor's risk status (IRD vs standard risk donor [SRD]). Recipients of IRD were categorized based on donor social behaviors (SB), and recipient survival was assessed. Cox regression analysis was used to identify associations between SB of donors and recipient survival. Results: Out of 22 333 heart transplantations performed during the study period, 2769 (12%) received an IRD graft with the following SB: Unprofessional tattoos or piercings (n = 1722) (63%), cocaine use (n = 916) (33%), heavy smoking (n = 437) (16%), and heavy alcohol abuse (n = 610) (22%). Viral screens detected 72(3%) hepatitis B virus (HBV) positive and 12 (0.4%) hepatitis C virus (HCV) positive at donation. There was no difference in recipient survival based on both donor risk and their social behaviors. Cox regression analysis found only donor HCV infection and non-identical ABO mismatch to be associated with poor recipient survival among recipients of IR grafts. Conclusion: Cardiac allografts from IRD, serologically negative for viruses, can safely be used. There is no association between social behaviors of IRD and recipient survival.
KW - heart failure
KW - heart transplant
KW - hepatitis
KW - increased-risk donor
U2 - https://doi.org/10.1111/ctr.13787
DO - https://doi.org/10.1111/ctr.13787
JO - Clinical Transplantation
JF - Clinical Transplantation
M1 - e13787
Okoh AK, Chan O, Schultheis M, Gupta M, Shah A, Gold J et al. Association between increased-risk donor social behaviors and recipient outcomes after heart transplantation. Clinical Transplantation. 2020 Mar 1;34(3):e13787. doi: https://doi.org/10.1111/ctr.13787