Impact of Donor-Recipient BMI Ratio on Survival Outcomes of Heart Transplant Recipients: A Retrospective Analysis Study

Objective: This study aimed to investigate the impact of the donor-recipient BMI ratio on the survival outcomes of heart transplant recipients. Methods: A retrospective analysis was conducted on 641 heart transplant patients who underwent surgery between September 2008 and June 2021. The BMI ratio (donor BMI divided by recipient BMI) was calculated for each patient. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed to evaluate survival rates and determine the hazard ratio (HR) for mortality. Results: Significant differences were found in donor age and donor-recipient height ratio between the BMI ratio groups. The BMI ratio >= 1 group had a higher mean donor age (37.27 +/- 10.54 years) compared to the BMI ratio < 1 group (34.72 +/- 11.82 years, p = 0.008), and a slightly higher mean donor-recipient height ratio (1.02 +/- 0.06 vs. 1.00 +/- 0.05, p = 0.002). The Kaplan-Meier survival analysis indicated that the survival rate in the BMI ratio >= 1 group was significantly lower than in the BMI ratio < 1 group. Cox multivariate analysis, adjusted for confounding factors, revealed a HR of 1.50 (95% CI: 1.08-2.09) for mortality in patients with a BMI ratio >= 1. No significant differences were observed in ICU stay, postoperative hospitalization days, or total mechanical ventilation time between the groups. Conclusion: A higher donor-recipient BMI ratio was associated with an increased risk of mortality in heart transplant recipients.