Heart Transplants from Severely Obese Donors Show Comparable Outcomes for Patients, Says Study

Heart transplant patients who received hearts from severely obese donors were found to have similar short-term outcomes and long-term survival as patients who received hearts from non-obese donors stated new research published today in Circulation: Heart Failure, an American Heart Association journal.

In the United States, the waiting list for a heart transplant is continuously about 3,000 people, and only half of those people receive a donor heart within a year. There is an urgent need to expand the pool of potential heart donors; however, transplant centers are hesitant to accept obese donors' hearts.

‘Donor obesity may not affect the outcomes of heart transplant.’

"As the prevalence of obesity in the U.S. continues to rise, it directly affects the pool of organ donors," said Leora T. Yarboro, M.D., lead study author and associate professor of surgery at the University of Virginia in Charlottesville, Virginia. "Since the prevalence of severe obesity has increased significantly over the past 15 years, we wanted to investigate the outcomes of recipients of transplant hearts from donors with severe obesity."

The national United Network for Organ Sharing (UNOS) database was used to analyze the outcomes of 26,000 heart transplants from 2003-2017.

• Approximately 900 of the donors had severe obesity.
• Severely obese donors, a BMI 40, were more likely to be older and female.
• 10% of severely obese donors had diabetes vs. 3% of non-obese donors.
• 33% of obese donors had hypertension vs. 15% of donors with BMI <40.
• Transplants from donors with severe obesity increased over time.

Study Results

No significant differences in post-transplant outcomes for patients who received a heart from a severely obese donor observed.

• Short-term outcomes, including postoperative stroke, acute rejection of the donor's heart, pacemaker need, and dialysis requirement, were similar for recipients of hearts from obese and non-obese donors.
• No difference in one-year survival rates and long-term mortality for patients with transplants from severely obese donors observed.

"These findings were somewhat surprising because the severely obese donors did tend to have more medical problems, such as diabetes and high blood pressure, than the non-obese donors," Yarboro said. "This study shows that with careful selection, hearts from obese donors can be used without an increased risk to the recipient. Given the continued increase in obesity in the U.S., this research has the potential to expand the critically low donor pool by increasing the number of donors and improving outcomes for the growing list of patients with end-stage heart failure."

Source: Medindia