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Donor history of malignancy: A limited risk for heart transplant recipients
Author(s) -
Rudasill Sarah E.,
Iyengar Amit,
Sanaiha Yas,
Khoury Habib,
Mardock Alexandra L.,
Sareh Sohail,
Benharash Peyman
Publication year - 2020
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.13762
Subject(s) - medicine , malignancy , proportional hazards model , transplantation , propensity score matching , heart transplantation , population , logistic regression , survival analysis , surgery , environmental health
Organ donor contraindications are frequently reassessed for impact on recipient outcomes in attempt to meet demand for transplantation. This study retrospectively analyzed the United Network for Organ Sharing (UNOS) registry for adult heart transplants from 1987 to September 2016 to characterize the impact of donor malignancy history in heart transplantation. Kaplan‐Meier estimates illustrated 10‐year survival. Propensity score matching was utilized for 1:1 matching of donors with and without history of malignancy, and Cox proportional hazards and logistic regressions were used to analyze the matched population. Of 38 781 heart transplants, 622 (1.6%) had a donor history of malignancy. Cox regressions demonstrated that donor malignancy predicted increased 10‐year mortality (HR = 1.16 [1.01‐1.33]), but this difference did not persist when conditioned upon 1 year post‐transplant survival (log‐rank = 0.643). Cox regressions of the propensity score‐matched population (455 pairs) found no association between donor malignancy and 10‐year mortality (HR = 1.02 [0.84‐1.24]). Older age and higher rates of hypertension were observed in donors with a history of malignancy whose recipients died within the first year post‐transplant. Therefore, increased recipient mortality is likely due to donor characteristics beyond malignancy, creating the potential for expanded donor selection.