2023 Volume 58 Issue 1 Pages 35-42
【Objective】 The severe organ donor shortage is a crucial issue for heart transplantation (HTx) in Japan. We have aggressively accepted marginal donor hearts declined by other institutions since 2016, when the waiting time for HTx increased gradually.
【Design】 This is a single center, retrospective observational study.
【Methods】 All HTx recipients at National Cerebral and Cardiovascular Center from 1999 to 2021 were reviewed and divided into two groups: those who underwent HTx from 1999 to 2015 (early HTx group), and those who underwent HTx from 2016 to 2021 (late HTx group). The participants’ characteristics including risk factors of donor hearts were compared between the two groups.
【Results】 Recipients in the late HTx group were older compared to the early HTx group; the late HTx group demonstrated a significantly longer waiting time for HTx. On comparison of donor characteristics, older age, shorter ischemic time, and lower-dose inotropic use were observed in the late HTx group compared to the early HTx group. However, the five-year overall survival was comparable between the two groups.
【Conclusion】 Older donor hearts were more aggressively used for HTx beginning in 2016. The disadvantages of these organs may be compensated by shorter ischemic time and lower-dose inotropic use, which resulted in a comparable five-year survival. Careful assessment of donors’ risk factors and recipient-donor matching might aid in further expanding the potential donor pool in Japan.
