- Note that this retrospective cohort study demonstrated an association between undersized-heart transplants and increased mortality.
- Be aware that cardiac size was not directly measured; these results would be strengthened by a study that directly measured cardiac mass pre-transplantation.
Although differences in body mass were not predictive of survival after heart transplantation, differences in predicted heart mass using those equations were related to survival up to 5 years after the operation, according to Robert Reed, MD, of the University of Maryland School of Medicine in Baltimore, and colleagues.
Specifically, patients who received the most undersized hearts had significantly increased risks of dying at 1 year (HR 1.25, 95% CI 1.02-1.54) and 5 years (HR 1.20, 95% CI 1.04-1.39), the researchers reported online in JACC: Heart Failure.
The study also pointed to heart size as an explanation for the worse transplant outcomes seen among men who receive donor hearts from women. Before adjustment, a sex mismatch between the donor and recipient was associated with increased mortality in male patients, but not in female patients. In a multivariate analysis that included predicted heart mass, a sex mismatch was no longer associated with survival in men.
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