Preservation Strategy and Sex-Specific Risk of Severe Primary Graft Dysfunction After Heart Transplantation: A GUARDIAN-Heart Analysis.

Document Type

Article

Publication Date

5-2026

Publication Title

ASAIO Journal

Abstract

Static controlled hypothermic donor heart transportation (SCTS) has been shown to improve survival and lower rates of severe primary graft dysfunction (PGD) after heart transplantation (HT) as compared to ice. The current study examined preservation strategy and sex-specific risk of PGD in the GUARDIAN-Heart registry. Adult HT recipients from October 2015 through July 2025 were included. A propensity-matched cohort was fit using nearest-neighbor matching to compare clinical outcomes by sex and preservation method. A total of 1,723 (29% women) HT recipients were included. In the propensity-matched cohort, rates of severe PGD in the SCTS group were comparable to ice despite significantly longer distance traveled and ischemic times in the SCTS group in both men and women. Women-SCTS experienced significantly lower rates of severe right ventricular (RV) dysfunction at 24 hours compared to the women-ICE group (1% vs . 14%, p < 0.001). One year survival was similar between ice and SCTS in men (92% vs . 95%, p = 0.15) and in women (96% vs . 94%, p = 0.54). Despite longer ischemic times and travel distances, the women-SCTS group had similar outcomes to the women-ice (NCT04141605).

Comments

Frederik Meijer Heart and Vascular Institute

DOI

10.1097/mat.0000000000002736

ISSN

1538-943X

PubMed ID

42127213

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