Impact of Donor Spontaneous Intracranial Hemorrhage on Outcome after Heart Transplantation

Mohamad H. Yamani*, Michael S. Lauer, Randall C. Starling, Claire E. Pothier, E. Murat Tuzcu, Norman B. Ratliff, Daniel J. Cook, Ashraf Abdo, Ann McNeil, Tim Crowe, Robert Hobbs, Gustavo Rincon, Corinne Bott-Silverman, Patrick M. McCarthy, James B. Young

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Donor cause of death has been suggested to have a significant impact on cardiac transplant morbidity and mortality. Our objective was to evaluate the impact of donor spontaneous intracranial bleeding on clinical outcome after heart transplantation. A group of 160 recipients underwent cardiac transplantation from donors with spontaneous intracranial bleeding (ICB group). These were compared with 197 recipients who were transplanted from trauma donors (Trauma group). A higher 4-year mortality rate was noted in the ICB group (24% vs. 14%, p = 0.015). ICB as a cause of donor death was an independent predictor of recipient mortality (adjusted hazard ratio 2.02, 95% CI 1.27-3.40, p < 0.0001). Compared with the Trauma group, the ICB group had an increased incidence of post-transplant graft dysfunction during the first week of transplant (10% vs. 3%, p = 0.007), and higher incidence of interstitial myocardial fibrosis on their endomyocardial biopsies within 4 weeks of transplant (21% vs. 9%, p = 0.0012). There was a trend towards an increased rate of allograft vasculopathy in the ICB group (competing risks adjusted hazard ratio 1.39, 95% CI 0.90-2.13, p = 0.14).

Original languageEnglish (US)
Pages (from-to)257-261
Number of pages5
JournalAmerican Journal of Transplantation
Volume4
Issue number2
DOIs
StatePublished - Feb 2004

Keywords

  • Allograft vasculopathy
  • Heart transplantation
  • Intracranial bleeding

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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