Prolonged corrected QT interval in the donor heart: Is there a risk?

Background Assessing the QT interval in donors is important to exclude long QT syndrome as the cause of death. A donor heart with a corrected QT ( QT c ) >500 milliseconds is often concerning. We sought to evaluate first year outcomes for donors with a QT c interval >500 milliseconds. Methods Between 2010 and 2014, we assessed 257 donor hearts for QT c interval >500 milliseconds. Post‐transplant outcomes included 1‐year survival, 1‐year freedom from any‐treated rejection, 1‐year freedom from cardiac allograft vasculopathy ( CAV ) defined as stenosis ≥30% by angiography, and 1‐year freedom from nonfatal major adverse cardiac events. Results Patients with QT c interval >500 milliseconds had a significantly lower 1‐year freedom from CAV development. There were no significant differences for other outcomes. A significantly higher percentage of donors with QT c >500 milliseconds had a stroke or subarachnoid hemorrhage. Multivariate analysis found that donor QT c >500 milliseconds was associated with a 6.7‐fold increased risk of developing CAV ( P =.029, 95% CI 1.21‐36.6) after adjusting for other known risk factors. Conclusion QT c >500 milliseconds in the donor heart appears to be an independent risk factor for the development of early CAV after heart transplantation possibly due to a higher immunological risk.