ArticleJHLT open2026
Donor coronary artery disease and outcomes after heart transplantation: Effect modification by donor age and allocation era.
Article in JHLT open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
10 authors.
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Abstract
Background: The limited availability of donor hearts has led to an increased utilization of organs from donors with pre-existing coronary artery disease (CAD). However, the impact of donor-transmitted CAD (DTCAD) on post-transplant outcomes stratified by donor age remains insufficiently characterized. Methods: Using the United Network for Organ Sharing database, adults undergoing orthotopic heart transplantation (2000 to 2025) were analyzed. Donors were stratified by age and CAD status on pre-procurement angiography. The primary outcome was all-cause mortality. Effect modification by donor age and allocation era was assessed using multivariable Cox regression. Results: Among 21,805 recipients (median follow-up 3.94 years), 1932 (8.9%) received hearts with CAD. DTCAD was not associated with mortality [hazard ratio (HR) 1.04; 95% confidence interval (CI) 0.95-1.13; Conclusions: DTCAD is not consistently associated with adverse outcomes. However, in the current era characterized by higher-acuity recipients, DTCAD, especially from older donors, is linked to increased mortality. These findings support re-evaluating donor CAD selection criteria in contemporary practice.
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