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Elevated donor hemoglobin A1c does not impair early survival in cardiac transplant recipients
Author(s) -
Joseph Jeremy T.,
Mulvihill Michael S.,
Yerokun Babatunde A.,
Bell Sadé M.,
Milano Carmelo A.,
Hartwig Matthew G.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12995
Subject(s) - medicine , glycemic , propensity score matching , diabetes mellitus , transplantation , heart transplantation , surgery , cardiology , endocrinology
Background Orthotopic heart transplantation ( OHT ) is the gold‐standard therapy for end‐stage heart failure. An increasing deficit between suitable allograft availability and clinical demand for OHT exists. The role of donor diabetes mellitus ( DM ) on post‐transplant recipient outcomes in OHT is controversial. The purpose of this study was to examine donor hemoglobin A1c (HbA1c) levels to identify the impact of donor glycemic control on recipient survival. Methods Adult OHT recipients with donor HbA1c data were identified in the UNOS database from 2010 to 2015. Recipients were stratified on the basis of donor glycemic status: Hyperglycemic‐donor and euglycemic‐donor cohorts were defined as HbA1c levels ≥6.5% and <6.5%, respectively. Outcomes were compared between unadjusted and propensity‐matched hyperglycemic versus euglycemic donors. Primary end point was three‐year survival. Results Of 5342 OHT recipients, 208 (3.89%) received an allograft from a hyperglycemic donor and 5134 (96.1%) received an allograft from a euglycemic donor. There was no significant difference in survival in the hyperglycemic group before ( P =.87) or after ( P =.78) propensity matching. Conclusions No difference in four‐year survival was noted in recipients who received allografts from hyperglycemic donors. These results suggest that recent cumulative donor glycemic status alone may not be an important predictor of recipient outcomes.