Right ventricular undersizing is associated with increased 1-year mortality

ObjectivesRight heart hemodynamic management is critical, because many post–heart transplantation (HTx) complications are related to right ventricular (RV) failure. However, current guidelines on size and sex matching rely primarily weight matching, with recent literature using total mass (TVM), which places less emphasis the impact of RV (RVM) matching. The aim present study was analyze relationship RVM survival after HTx.MethodsWe performed retrospective analysis UNOS database adult HTx between January 1997 December 2017. Previously validated equations were used calculate TVM RVM. percent difference in donor recipient pair for mismatch. All donor-recipient pairs divided into 4 groups by their mismatch ratio. We analyzed explored how undersizing impacted outcomes. primary outcome measure 1-year survival; secondary outcomes measured included stroke dialysis within 1 year functional status.ResultsA 38,740 our study. match groupings as follows: <0%, 0% 20%, 20% 40%, >40%. Utilization donors who older female resulted greater undersizing. Survival demonstrated patients had worse (P < .001). an independent predictor higher mortality (hazard ratio, 1.23; 95% confidence interval, 1.11 1.34; P also associated rates poorer postoperative status.ConclusionsRVM survival. Donors have lower absolute predicted may be predisposed RVM-undersized requires careful risk/benefit considerations.