(502) Obese Donors in Heart Transplantation: Hemodynamic Assessment and Survival

Abstract

Purpose: Donor body mass index (BMI) has been increasing over time in heart transplantation, mirroring the trends in the general population. Our purpose was to assess the survival and right heart hemodynamics in heart transplant recipients from donors with BMI ≥ 30 kg/m2. Methods: We retrospectively divided our heart transplant population from 2007 through July 2019 into two groups: donor BMI < 30 kg/m2 (non-obese donor) and donor BMI ≥ 30 kg/m2 (obese donor). We recorded baseline donor and recipient characteristics. Outcomes were one and three-year survival and hemodynamics from right heart catheterization at one year. Results: A total of 257 heart transplant recipients were included with 100 patients in obese donor group and 157 patients in non-obese donor group. Twenty-eight of the 100 obese donor patients had a donor BMI > 40 kg/m2. Clinical characteristics and results are shown in the table (* p < 0.05 obese donor versus non-obese donor). Obese donors were more likely to be female and were significantly older than non-obese donors. Both 1-year and 3-year survival in the obese donor group were excellent and compared favorably to the non-obese donor group. In those patients who survived to 1 year and in whom right heart catheterization data was available at 1 year (97 patients in obese donor group and 141 in non-obese donor group), right atrial and pulmonary artery (PA) pressures were significantly higher in the obese donor group compared to non-obese. Pulmonary capillary wedge pressure (PCWP) was not different between the 2 groups. Conclusion: Allograft hearts from obese donors can be used in heart transplantation with excellent 1-year and 3-year survival. In our patient population, we demonstrated significantly higher right atrial and PA pressures in recipients of obese donors at 1-year post-transplant, although the absolute increase compared to the non-obese group was small.