Effects of Nighttime Procurement and Transplantation on Outcomes Following Heart Transplantation

• DOI: 10.1111/ctr.70093
• Publication Date: 2025-01-30T15:00:29Z
• Authors: Yeahwa Hong; Nicholas R. Hess; Ander Dorken‐Gall...; Mohamed Abdullah; Nidhi Iyanna; Umar Nasim; Ibrahim Sultan; Gavin W. Hickey; Mary E. Keebler; David J. Kaczorowski

ABSTRACT Background This study evaluates the effects of nighttime procurement and transplantation on outcomes following heart transplantation. Methods The UNOS registry was queried to analyze adult recipients who underwent isolated orthotopic between January 1, 2010, September 30, 2022. cohort stratified into daytime (4 am–8 pm) (8 pm–4 am) transplant groups. primary outcome 1‐year survival. Propensity score‐matching performed. Risk adjustment performed using multivariable Cox regression. Restricted cubic spline used model association time likelihood mortality. Sub‐analysis evaluate impact procurement. Results Altogether 30 426 were analyzed, where 10 807 (35.5%) had reduced post‐transplant survival compared (90.6% vs. 91.5%, p = 0.019), this lower persisted in propensity score‐matched comparison. After adjusting for established predictors mortality, continued have a significantly increased risk mortality (hazard ratio [HR] 1.12, 95% confidence interval [CI] 1.03–1.21, 0.005). demonstrated odds 5 pm 4 am, with highest at 11 (odds [OR] 1.25, CI 1.07–1.47), reference 7 am. When assessing timing, negatively impacted among recipients. Conclusion demonstrates adverse early With emerging organ perfusion thermal protection systems, additional studies are warranted assess safety extending preservation period optimize timing