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| Natura: | Artículo Open Access |
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Wiley
2026
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| Accesso online: | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70439 |
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| author | Ye In Christopher Kwon Brian Bao Jack Guiry David T. Zhu Alan Lai Matthew Ambrosio Aditya Kesari Jay Patel Zachary Fitch Josue Chery Patricia Nicolato Vigneshwar Kasirajan Zubair A. Hashmi |
| author_facet | Ye In Christopher Kwon Brian Bao Jack Guiry David T. Zhu Alan Lai Matthew Ambrosio Aditya Kesari Jay Patel Zachary Fitch Josue Chery Patricia Nicolato Vigneshwar Kasirajan Zubair A. Hashmi Ye In Christopher Kwon Brian Bao Jack Guiry David T. Zhu Alan Lai Matthew Ambrosio Aditya Kesari Jay Patel Zachary Fitch Josue Chery Patricia Nicolato Vigneshwar Kasirajan Zubair A. Hashmi |
| collection | Wiley Open Access |
| contents | Evolving Long‐Term Outcomes of Heart Transplantation Using COVID‐19 Positive Donors Ye In Christopher Kwon Brian Bao Jack Guiry David T. Zhu Alan Lai Matthew Ambrosio Aditya Kesari Jay Patel Zachary Fitch Josue Chery Patricia Nicolato Vigneshwar Kasirajan Zubair A. Hashmi Clinical Transplantation ABSTRACT Background As COVID‐19 becomes endemic, evaluating COVID‐19+ donors for heart transplantation (HT) remains important. We assessed long‐term outcomes using national data and propensity‐matched analysis. Methods All adults (>18 years) undergoing HT between 4/2020 and 9/2024 were identified in the UNOS database. They were stratified into COVID‐19+ versus –, defined by either a positive nucleic acid or antigen test within 7 days of HT. Groups were then 3:1 nearest propensity score matched. Survival was estimated by the Kaplan–Meier method. Mortality risk was assessed using Cox regression models. Results A total of 879 recipients of COVID‐19– hearts were matched with 293 recipients of COVID‐19+ hearts. We found no significant differences in 3‐year landmark survival between cohorts ( p = 0.23). Rates of acute rejection ( p = 0.15), length of hospital stay (LOS) ( p > 0.9), and postoperative stroke ( p = 0.53) did not differ significantly between groups. However, dialysis (17% vs. 12%, p = 0.04) and primary graft dysfunction rates at 24‐h post‐HT were significantly higher in COVID‐19+ heart recipients (5.5% vs. 1.8%, p = 0.01). Donor COVID‐19+ status was not significantly associated with mortality risk (HR 1.01, p = 0.66). COVID‐19+ donor HTs in recent years (2022–2024) were associated with decreased mortality risk (HR 0.82, p = 0.02), rates of acute rejection ( p < 0.001), LOS ( p = 0.01), and dialysis (18% vs. 8.9%, p = 0.03). Conclusions COVID‐19+ hearts demonstrate adequate long‐term outcomes, particularly in recent years. Future studies should assess the impact of donor vaccination to optimize survival benefits. 10.1111/ctr.70439 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| doi_str_mv | 10.1111/ctr.70439 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70439 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Evolving Long‐Term Outcomes of Heart Transplantation Using COVID‐19 Positive Donors Ye In Christopher Kwon Brian Bao Jack Guiry David T. Zhu Alan Lai Matthew Ambrosio Aditya Kesari Jay Patel Zachary Fitch Josue Chery Patricia Nicolato Vigneshwar Kasirajan Zubair A. Hashmi Clinical Transplantation Evolving Long‐Term Outcomes of Heart Transplantation Using COVID‐19 Positive Donors Ye In Christopher Kwon Brian Bao Jack Guiry David T. Zhu Alan Lai Matthew Ambrosio Aditya Kesari Jay Patel Zachary Fitch Josue Chery Patricia Nicolato Vigneshwar Kasirajan Zubair A. Hashmi Clinical Transplantation ABSTRACT Background As COVID‐19 becomes endemic, evaluating COVID‐19+ donors for heart transplantation (HT) remains important. We assessed long‐term outcomes using national data and propensity‐matched analysis. Methods All adults (>18 years) undergoing HT between 4/2020 and 9/2024 were identified in the UNOS database. They were stratified into COVID‐19+ versus –, defined by either a positive nucleic acid or antigen test within 7 days of HT. Groups were then 3:1 nearest propensity score matched. Survival was estimated by the Kaplan–Meier method. Mortality risk was assessed using Cox regression models. Results A total of 879 recipients of COVID‐19– hearts were matched with 293 recipients of COVID‐19+ hearts. We found no significant differences in 3‐year landmark survival between cohorts ( p = 0.23). Rates of acute rejection ( p = 0.15), length of hospital stay (LOS) ( p > 0.9), and postoperative stroke ( p = 0.53) did not differ significantly between groups. However, dialysis (17% vs. 12%, p = 0.04) and primary graft dysfunction rates at 24‐h post‐HT were significantly higher in COVID‐19+ heart recipients (5.5% vs. 1.8%, p = 0.01). Donor COVID‐19+ status was not significantly associated with mortality risk (HR 1.01, p = 0.66). COVID‐19+ donor HTs in recent years (2022–2024) were associated with decreased mortality risk (HR 0.82, p = 0.02), rates of acute rejection ( p < 0.001), LOS ( p = 0.01), and dialysis (18% vs. 8.9%, p = 0.03). Conclusions COVID‐19+ hearts demonstrate adequate long‐term outcomes, particularly in recent years. Future studies should assess the impact of donor vaccination to optimize survival benefits. 10.1111/ctr.70439 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| title | Evolving Long‐Term Outcomes of Heart Transplantation Using COVID‐19 Positive Donors |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70439 |