Evidence map›Paper›PMID 35488767›Full record

ArticleJournal of cardiac surgery2022

Determining optimal donor heart ischemic times in adult cardiac transplantation.

Paul C Tang, Xiaoting Wu, Min Zhang, Donald Likosky, Jonathan W Haft, Ienglam Lei, Ashraf Abou El Ela, Ming-Sing Si, Keith D Aaronson, Francis D Pagani

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiac surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Review
  8. Article
  9. Heart Transplantation.Journal of clinical medicine · 2024
    Review
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Paul C TangDepartment of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0003-4211-8587
Xiaoting WuDepartment of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.
Min ZhangDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Ann Arbor, Michigan, USA.
Donald LikoskyDepartment of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.
Jonathan W HaftDepartment of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.
Ienglam LeiDepartment of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.
Ashraf Abou El ElaDepartment of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.
Ming-Sing SiDivision of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, California, USA.
Keith D AaronsonDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.
Francis D PaganiDepartment of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Michigan, USA.

Funding

Targeting Immune-Responsive Gene 1 (Irg1) and Itaconate for Cardioprotection of the Donor Heart for TransplantationR01HL164416 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Paul Tang · 2022 to 2026
$3.3M
Targeting Mineralocorticoid Receptor Condensates to Optimize Donor Heart PreservationR01HL166140 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Paul Tang · 2023 to 2026
$2.7M
NHLBI NIH HHS R01 HL164416NHLBI NIH HHS R01 HL166140
6 · The paper itself

Abstract

objectivesUnsupervised statistical determination of optimal allograft ischemic time (IT) on heart transplant outcomes among ABO donor heart types.

methodsWe identified 36,145 heart transplants (2000-2018) from the United Network for Organ Sharing database. Continuous and categorical variables were analyzed with parametric and nonparametric testing. Determination of IT cutoffs for survival analysis was performed using Contal and O'Quigley univariable method and Vito Muggeo multivariable segmented modeling.

resultsUnivariable and multivariable IT threshold determination revealed a cutoff at about 3 h. The hourly increase in survival risk with ≥3 h IT is asymmetrically experienced at the early 90 days (hazard ratio [HR] = 1.29, p < .001) and up to 1-year time point (HR = 1.16, p < .001). Beyond 1 year the risk of prolonged IT is less impactful (HR = 1.04, p = .022). Longer IT was associated with more postoperative complications such as stroke (2.7% vs. 2.3, p = .042), dialysis (11.6% vs. 9.1%, p < .001) and death from primary graft dysfunction (1.8% vs. 1.2%, p < .001). O blood type donor hearts with IT ≥ 3 h has significantly increased hourly mortality risk at 90 days (HR = 1.27, p < .001), 90 days to 1 year (HR = 1.22, p < .001) and >1 year (HR = 1.05, p = .041). For non-O blood types with ≥3 h IT hourly mortality risk was increased at 90 days (HR = 1.33, p < .001), but not at 90 days to 1 year (HR = 1.09, p = .146) nor ≥1 year (HR = 1.08, p = .237).

conclusionsThe donor heart IT threshold for survival determined from unbiased statistical modeling occurs at 3 h. With longer preservation times, transplantation with O donor hearts was associated with worse survival.

Indexed as

Heart TransplantationAdultGraft SurvivalHumansProportional Hazards ModelsRenal DialysisRetrospective StudiesSurvival AnalysisTissue Donorsmyocardial protectionreperfusiontransplantation-heart

Identifiers

PMID35488767
PMCPMC9325483

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.