THE IMPACT OF CARDIAC ARREST RESUSCITATED DONORS ON HEART TRANSPLANTATION OUTCOMES

Background: Heart transplantation (HTX) is the treatment of choice in patients with end-stage heart failure, even if it is still disadvantaged by lack of donor organs. The aim of this study was to compare heart transplant outcomes between recipients of hearts from cardiopulmonary-resuscitated (CPR+) donors and those from non-cardiopulmonary-resuscitated (CPR–) donors. Methods: This retrospective study included adults who underwent HTX at the University Hospital of Bologna from January 2006 to December 2023.We divided patients into two groups according to the history of cardiac arrest with an identified cause in donors (CPR+ vs CPR-). Survival rates were reported using Kaplan–Meier analysis and compared with the log-rank test. Results: A total of 402 patients were analyzed, 64 of which were transplanted with hearts from CPR+ donors. The 30-day mortality in the two groups were respectively 3.8%(CPR-) and 4.6%(CPR+). This difference was not statistically significant (p = 0.724). One and 5-year survival comparing the CPR- and CPR + groups was 82.7% versus 71.8% (p = 0.121) and 52.4% versus 48.7% (p = 0.548) respectively. There was no significant difference between the two groups in terms of postoperative incidence of renal dysfunction and intrahospital infection. Furthermore, no significant difference was found in needing of additional circulatory support with IABP or ECMO and frequency of donor organ failure. Conclusions: There is no evidence that cardiac transplantation outcomes and survival are adversely affected by a CPR in donors. Therefore, a history of CPR in donor should not preclude organ transplantability.