Donor Drug Use Not Tied to Survival for Heart Transplant Recipients
And risk for posttransplant death decreasing despite drug overdose, hepatitis C-positive donors contributing to donor risk
WEDNESDAY, July 28, 2021 (HealthDay News) -- Toxicological evidence of drug use for donors accepted for heart transplantation is not associated with recipient survival, and overall recipient survival continues to improve, according to two studies published online June 28 in Circulation: Heart Failure and the Journal of the American Heart Association.
David A. Baran, M.D., from Sentara Heart Hospital in Norfolk, Virginia, and colleagues examined long-term survival for 23,748 heart transplants performed between 2007 and 2017. The researchers found that during the study period, the number and percent of donors with drug use increased significantly. There were no differences in posttransplant mortality in modeling of survival, which included toxicological and historical data. There were no associations observed for combinations of drugs identified by toxicology with differences in survival.
Naga Dharmavaram, M.D., from the University of Wisconsin Hospital and Clinics in Madison, and colleagues examined characteristics of donors and recipients from 2008 to 2012 and 2013 to 2017 versus 2003 to 2007 (11,654 and 14,556, respectively, versus 10,869). The researchers found that between 2013 and 2017, donors were older, heavier, more likely to have hypertension and diabetes, and more likely to have abused illicit drugs than in earlier years. In recent years, drug overdose and hepatitis C-positive donors were additional contributors to donor risk. Compared with 2003 to 2007, the risk for posttransplant death was lower at 30 days and one year in 2013 to 2017 (hazard ratios [95 percent confidence intervals], 0.85 [0.74 to 0.98] and 0.79 [0.73 to 0.87], respectively) and in 2008 to 2012 (hazard ratios [95 percent confidence interval], 0.91 [0.79 to 1.05] and 0.86 [0.79 to 0.94], respectively).
"This research confirms previous data that these hearts -- once considered high risk -- are safe," Howard Eisen, M.D., from the American Heart Association Heart Failure and Transplantation Committee of the Clinical Cardiology Council, said in a statement. "These findings should encourage institutions who are not routinely using hearts from drug users to do so."
Several authors from the Baran study disclosed financial ties to the pharmaceutical industry.