The effect of donor alcohol abuse on outcomes following heart transplantation

Joshua Newman, Max Liebo, Brian D Lowes, Haseeb Ilias Basha, Yael Peled, Emily Cendrowski, Ronald Zolty, Dylan Douglas, John Y Um, Edwin McGee, Alain Heroux, Eugenia Raichlin

Research output: Contribution to journalArticle

Abstract

Background: Current guidelines recommend against the use of hearts from donors that abuse alcohol. We explored the effect of donor alcohol abuse (AA) on cardiac allograft function and outcomes in heart transplant (HTx) recipients. Methods: Overall, 370 HTx recipients were divided into two groups: (a) the alcoholic donor group (AD, n = 58) and (b) the non-alcoholic donor group (NAD, n = 312). Results: Recipients in the AD group had a slower heart rate (86 ± 13 vs 93 ± 13, P = 0.004) and an increased incidence of early atrial fibrillation (AF) (30% vs 11%, P = 0.003). Echocardiographic left ventricular mass was higher among alcoholic donors (171.7 ± 66.7 vs 151.6 ± 54.7, P = 0.02). This difference remained present 1 year following HTx (185 ± 43 vs 166 ± 42, P = 0.007). E/E′ was higher in the AD group (9.5 ± 3.9 vs 8.4 ± 2.9, P = 0.04) and a larger number of AD recipients had a ventilatory equivalent for VCO2> 34 (50% vs 31%, P = 0.04) on cardiopulmonary exercise test. There was no significant difference in rejection, cardiac allograft vasculopathy (CAV), or survival between the groups. Conclusions: Our data suggest that donor AA does not impact rejection, CAV, or intermediate-term survival, but may cause increased incidence of post-HTx AF and impaired cardiac allograft diastolic function.

Original languageEnglish (US)
Article numbere13461
JournalClinical Transplantation
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Heart Transplantation
Alcoholism
Tissue Donors
Allografts
Alcoholics
Atrial Fibrillation
Survival
Incidence
Exercise Test
NAD
Heart Rate
Guidelines

Keywords

  • atrial fibrillation
  • diastolic dysfunction
  • donor characteristics
  • heart transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Newman, J., Liebo, M., Lowes, B. D., Ilias Basha, H., Peled, Y., Cendrowski, E., ... Raichlin, E. (Accepted/In press). The effect of donor alcohol abuse on outcomes following heart transplantation. Clinical Transplantation, [e13461]. https://doi.org/10.1111/ctr.13461

The effect of donor alcohol abuse on outcomes following heart transplantation. / Newman, Joshua; Liebo, Max; Lowes, Brian D; Ilias Basha, Haseeb; Peled, Yael; Cendrowski, Emily; Zolty, Ronald; Douglas, Dylan; Um, John Y; McGee, Edwin; Heroux, Alain; Raichlin, Eugenia.

In: Clinical Transplantation, 01.01.2019.

Research output: Contribution to journalArticle

Newman, J, Liebo, M, Lowes, BD, Ilias Basha, H, Peled, Y, Cendrowski, E, Zolty, R, Douglas, D, Um, JY, McGee, E, Heroux, A & Raichlin, E 2019, 'The effect of donor alcohol abuse on outcomes following heart transplantation', Clinical Transplantation. https://doi.org/10.1111/ctr.13461
Newman, Joshua ; Liebo, Max ; Lowes, Brian D ; Ilias Basha, Haseeb ; Peled, Yael ; Cendrowski, Emily ; Zolty, Ronald ; Douglas, Dylan ; Um, John Y ; McGee, Edwin ; Heroux, Alain ; Raichlin, Eugenia. / The effect of donor alcohol abuse on outcomes following heart transplantation. In: Clinical Transplantation. 2019.
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abstract = "Background: Current guidelines recommend against the use of hearts from donors that abuse alcohol. We explored the effect of donor alcohol abuse (AA) on cardiac allograft function and outcomes in heart transplant (HTx) recipients. Methods: Overall, 370 HTx recipients were divided into two groups: (a) the alcoholic donor group (AD, n = 58) and (b) the non-alcoholic donor group (NAD, n = 312). Results: Recipients in the AD group had a slower heart rate (86 ± 13 vs 93 ± 13, P = 0.004) and an increased incidence of early atrial fibrillation (AF) (30{\%} vs 11{\%}, P = 0.003). Echocardiographic left ventricular mass was higher among alcoholic donors (171.7 ± 66.7 vs 151.6 ± 54.7, P = 0.02). This difference remained present 1 year following HTx (185 ± 43 vs 166 ± 42, P = 0.007). E/E′ was higher in the AD group (9.5 ± 3.9 vs 8.4 ± 2.9, P = 0.04) and a larger number of AD recipients had a ventilatory equivalent for VCO2> 34 (50{\%} vs 31{\%}, P = 0.04) on cardiopulmonary exercise test. There was no significant difference in rejection, cardiac allograft vasculopathy (CAV), or survival between the groups. Conclusions: Our data suggest that donor AA does not impact rejection, CAV, or intermediate-term survival, but may cause increased incidence of post-HTx AF and impaired cardiac allograft diastolic function.",
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AU - Newman, Joshua

AU - Liebo, Max

AU - Lowes, Brian D

AU - Ilias Basha, Haseeb

AU - Peled, Yael

AU - Cendrowski, Emily

AU - Zolty, Ronald

AU - Douglas, Dylan

AU - Um, John Y

AU - McGee, Edwin

AU - Heroux, Alain

AU - Raichlin, Eugenia

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N2 - Background: Current guidelines recommend against the use of hearts from donors that abuse alcohol. We explored the effect of donor alcohol abuse (AA) on cardiac allograft function and outcomes in heart transplant (HTx) recipients. Methods: Overall, 370 HTx recipients were divided into two groups: (a) the alcoholic donor group (AD, n = 58) and (b) the non-alcoholic donor group (NAD, n = 312). Results: Recipients in the AD group had a slower heart rate (86 ± 13 vs 93 ± 13, P = 0.004) and an increased incidence of early atrial fibrillation (AF) (30% vs 11%, P = 0.003). Echocardiographic left ventricular mass was higher among alcoholic donors (171.7 ± 66.7 vs 151.6 ± 54.7, P = 0.02). This difference remained present 1 year following HTx (185 ± 43 vs 166 ± 42, P = 0.007). E/E′ was higher in the AD group (9.5 ± 3.9 vs 8.4 ± 2.9, P = 0.04) and a larger number of AD recipients had a ventilatory equivalent for VCO2> 34 (50% vs 31%, P = 0.04) on cardiopulmonary exercise test. There was no significant difference in rejection, cardiac allograft vasculopathy (CAV), or survival between the groups. Conclusions: Our data suggest that donor AA does not impact rejection, CAV, or intermediate-term survival, but may cause increased incidence of post-HTx AF and impaired cardiac allograft diastolic function.

AB - Background: Current guidelines recommend against the use of hearts from donors that abuse alcohol. We explored the effect of donor alcohol abuse (AA) on cardiac allograft function and outcomes in heart transplant (HTx) recipients. Methods: Overall, 370 HTx recipients were divided into two groups: (a) the alcoholic donor group (AD, n = 58) and (b) the non-alcoholic donor group (NAD, n = 312). Results: Recipients in the AD group had a slower heart rate (86 ± 13 vs 93 ± 13, P = 0.004) and an increased incidence of early atrial fibrillation (AF) (30% vs 11%, P = 0.003). Echocardiographic left ventricular mass was higher among alcoholic donors (171.7 ± 66.7 vs 151.6 ± 54.7, P = 0.02). This difference remained present 1 year following HTx (185 ± 43 vs 166 ± 42, P = 0.007). E/E′ was higher in the AD group (9.5 ± 3.9 vs 8.4 ± 2.9, P = 0.04) and a larger number of AD recipients had a ventilatory equivalent for VCO2> 34 (50% vs 31%, P = 0.04) on cardiopulmonary exercise test. There was no significant difference in rejection, cardiac allograft vasculopathy (CAV), or survival between the groups. Conclusions: Our data suggest that donor AA does not impact rejection, CAV, or intermediate-term survival, but may cause increased incidence of post-HTx AF and impaired cardiac allograft diastolic function.

KW - atrial fibrillation

KW - diastolic dysfunction

KW - donor characteristics

KW - heart transplantation

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