Heart Transplant Recipients of Donors with Intracranial Hemorrhage Have Worse Survival

PurposeA significant proportion of heart transplant donors suffer death from intracranial hemorrhage. We sought to determine if recipients of donors who die due to intracranial hemorrhage have worse outcomes post heart transplant.MethodsThe United Network for Organ Sharing database was queried from 2006 to 2020 for all adult recipients who underwent heart transplant. Survival was compared for recipients of donors with intracranial hemorrhage versus all other causes of death. Recipients were then identified if the donor cause of death was cerebrovascular, stroke or head trauma. Survival was compared for recipients of donors with intracranial hemorrhage and donors with nonhemorrhagic stroke or head trauma within this sub-group.ResultsA total of 31,599 patients underwent heart transplant during the study time period, with 6362 patients whose donor died due to intracranial hemorrhage. A total of 15,914 patients received a heart from a donor with an intracranial cause of death. Demographic information is shown in table 1. Survival was significantly worse for recipients of donors who died from intracranial hemorrhage (Figure 1, p<0.001). When survival was compared for recipients whose donor had an intracranial cause of death, intracranial hemorrhage resulted in worse survival compared with a nonhemorrhagic cause of death (p<0.001). Analysis of the cause of death showed a higher rate of graft failure in recipients of donors with intracranial hemorrhage (N=257, 13.4% vs. N=699, 11.9%, p<0.001).ConclusionDonors who die from intracranial hemorrhage should be considered with caution and should be matched carefully with the appropriate recipient. A significant proportion of heart transplant donors suffer death from intracranial hemorrhage. We sought to determine if recipients of donors who die due to intracranial hemorrhage have worse outcomes post heart transplant. The United Network for Organ Sharing database was queried from 2006 to 2020 for all adult recipients who underwent heart transplant. Survival was compared for recipients of donors with intracranial hemorrhage versus all other causes of death. Recipients were then identified if the donor cause of death was cerebrovascular, stroke or head trauma. Survival was compared for recipients of donors with intracranial hemorrhage and donors with nonhemorrhagic stroke or head trauma within this sub-group. A total of 31,599 patients underwent heart transplant during the study time period, with 6362 patients whose donor died due to intracranial hemorrhage. A total of 15,914 patients received a heart from a donor with an intracranial cause of death. Demographic information is shown in table 1. Survival was significantly worse for recipients of donors who died from intracranial hemorrhage (Figure 1, p<0.001). When survival was compared for recipients whose donor had an intracranial cause of death, intracranial hemorrhage resulted in worse survival compared with a nonhemorrhagic cause of death (p<0.001). Analysis of the cause of death showed a higher rate of graft failure in recipients of donors with intracranial hemorrhage (N=257, 13.4% vs. N=699, 11.9%, p<0.001). Donors who die from intracranial hemorrhage should be considered with caution and should be matched carefully with the appropriate recipient.