Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death
Background: Recent studies indicate that donor innate immune responses participate in initiating and accelerating innate responses and allorecognition in the recipient. These immune responses negatively affect recipient outcomes and predispose recipients to cardiovascular death (CV death). We hypoth...
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| Format: | Article |
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/24/7629 |
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| author | Margo E. Hammond Charles Zollinger Andrija Vidic Gregory L. Snow Joseph Stehlik Rami A. Alharethi Abdallah G. Kfoury Stavros Drakos M Elizabeth H. Hammond |
| author_facet | Margo E. Hammond Charles Zollinger Andrija Vidic Gregory L. Snow Joseph Stehlik Rami A. Alharethi Abdallah G. Kfoury Stavros Drakos M Elizabeth H. Hammond |
| author_sort | Margo E. Hammond |
| collection | DOAJ |
| description | Background: Recent studies indicate that donor innate immune responses participate in initiating and accelerating innate responses and allorecognition in the recipient. These immune responses negatively affect recipient outcomes and predispose recipients to cardiovascular death (CV death). We hypothesized that a donor cause of death (COD) associated with higher levels of innate immune response would predispose recipients to more adverse outcomes post-transplant, including CV death. Methods: We performed a single-institution retrospective analysis comparing donor characteristics and COD to recipient adverse cardiovascular outcomes. We analyzed the medical records of local adult donors (age 18–64) in a database of donors where adequate data was available. Donor age was available on 706 donors; donor sex was available on 730 donors. We linked donor characteristics (age and sex) and COD to recipient CV death. The data were analyzed using logistic regression, the log-rank test of differences, and Tukey contrast. Results: Donor age, female sex, and COD of intracranial hemorrhage were significantly associated with a higher incidence of recipient CV death. Conclusions: In this single institution study, we found that recipients with hearts from donors over 40 years, donors who were female, or donors who died with a COD of intracranial hemorrhage had a higher frequency of CV death. Donor monitoring and potential treatment of innate immune activation may decrease subsequent recipient innate responses and allorecognition stimulated by donor-derived inflammatory signaling, which leads to adverse outcomes. |
| first_indexed | 2024-03-08T20:39:01Z |
| format | Article |
| id | doaj.art-8f9695022a4a4c519542cc46e768c5f0 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T20:39:01Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8f9695022a4a4c519542cc46e768c5f02023-12-22T14:17:15ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011224762910.3390/jcm12247629Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac DeathMargo E. Hammond0Charles Zollinger1Andrija Vidic2Gregory L. Snow3Joseph Stehlik4Rami A. Alharethi5Abdallah G. Kfoury6Stavros Drakos7M Elizabeth H. Hammond8Department of Biochemistry, Brigham Young University, Provo, UT 84602, USAIntermountain Donor Services, 6065 S Fashion Blvd, Murray, UT 84107, USADepartment of Cardiology, University of Kansas Hospital, 4000 Cambridge St., Kansas City, KS 66160, USADepartment of Statistics, Brigham Young University, Provo, UT 84602, USADepartment of Cardiology, University of Utah Hospital, 50 N Medical Drive, Salt Lake City, UT 84132, USACardiac Transplant Program, Intermountain Medical Center, 5252 S Intermountain Drive, Salt Lake City, UT 84157, USACardiac Transplant Program, Intermountain Medical Center, 5252 S Intermountain Drive, Salt Lake City, UT 84157, USADepartment of Cardiology, University of Utah Hospital, 50 N Medical Drive, Salt Lake City, UT 84132, USADepartment of Cardiology, University of Utah Hospital, 50 N Medical Drive, Salt Lake City, UT 84132, USABackground: Recent studies indicate that donor innate immune responses participate in initiating and accelerating innate responses and allorecognition in the recipient. These immune responses negatively affect recipient outcomes and predispose recipients to cardiovascular death (CV death). We hypothesized that a donor cause of death (COD) associated with higher levels of innate immune response would predispose recipients to more adverse outcomes post-transplant, including CV death. Methods: We performed a single-institution retrospective analysis comparing donor characteristics and COD to recipient adverse cardiovascular outcomes. We analyzed the medical records of local adult donors (age 18–64) in a database of donors where adequate data was available. Donor age was available on 706 donors; donor sex was available on 730 donors. We linked donor characteristics (age and sex) and COD to recipient CV death. The data were analyzed using logistic regression, the log-rank test of differences, and Tukey contrast. Results: Donor age, female sex, and COD of intracranial hemorrhage were significantly associated with a higher incidence of recipient CV death. Conclusions: In this single institution study, we found that recipients with hearts from donors over 40 years, donors who were female, or donors who died with a COD of intracranial hemorrhage had a higher frequency of CV death. Donor monitoring and potential treatment of innate immune activation may decrease subsequent recipient innate responses and allorecognition stimulated by donor-derived inflammatory signaling, which leads to adverse outcomes.https://www.mdpi.com/2077-0383/12/24/7629innate immunityintracranial hemorrhageheart transplantationdonor factorsantibody mediated rejectioncardiovascular death |
| spellingShingle | Margo E. Hammond Charles Zollinger Andrija Vidic Gregory L. Snow Joseph Stehlik Rami A. Alharethi Abdallah G. Kfoury Stavros Drakos M Elizabeth H. Hammond Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death Journal of Clinical Medicine innate immunity intracranial hemorrhage heart transplantation donor factors antibody mediated rejection cardiovascular death |
| title | Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death |
| title_full | Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death |
| title_fullStr | Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death |
| title_full_unstemmed | Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death |
| title_short | Donor Age, Sex, and Cause of Death and Their Relationship to Heart Transplant Recipient Cardiac Death |
| title_sort | donor age sex and cause of death and their relationship to heart transplant recipient cardiac death |
| topic | innate immunity intracranial hemorrhage heart transplantation donor factors antibody mediated rejection cardiovascular death |
| url | https://www.mdpi.com/2077-0383/12/24/7629 |
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