Patient outcomes stay the same when heart transplants are from severely obese donors

Roughly 3,000 people in the United States are on the heart transplant waiting list at any given time, a statistic made even worse by the fact that many transplant centers flat-out reject hearts from obese donors.

According to new research published in Circulation: Heart Failure, however, heart transplants from severely obese donors result in outcomes similar to those from healthier donors.

The study’s authors assessed the outcomes of 26,000 heart transplants, relying on the United Network for Organ Sharing database. All procedures occurred from 2003 to 2017, and 3.5% of all donors were severely obese, which was defined as a BMI equal or greater to 40.

Overall, 10% of the severely obese donors had diabetes, up from 3% of non-obese donors. Also, 33% of obese donors had hypertension, double the percentage of non-obese donors.

Even though 67% of heart transplants from severely obese donors were size mismatched, meaning the donor’s weight was much greater than the recipient’s weight, the team found that no significant differences in post-transplant outcomes between the two groups. One-year survival rates and long-term mortality were also comparable between patients who received transplants from obese patients and non-obese patients.

“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,” lead author Leora T. Yarboro, MD, a professor of surgery at the University of Virginia in Charlottesville, said in a prepared statement. “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.”

The full analysis from Circulation: Heart Failure is available here.