Increases in donor/recipient predicted heart mass ratios do not result in large donor right ventricles

Pulmonary hypertension puts strain on the right ventricle (RV), leading to the widespread practice of oversizing donor hearts to mitigate complications. However, contemporary evidence for this practice is neutral. We studied the relationship between donor-recipient predicted heart mass (D/R PHM) ratios and increases in donor left ventricle (LV) and RV mass. We also studied the relationship between predicted D/R PHM ratios and predicted D/R LV mass difference and RV mass difference. We find that increases in D/R PHM ratios result in minimal change in donor RV mass as well as minimal change in predicted D/R RV mass difference. However, increases in D/R PHM ratios were associated with marked increases in predicted D/R LV mass difference. We conclude that the utilization of donors with high predicted D/R PHM ratios generally does not result in the delivery of larger RVs to transplant recipients, but predominantly the delivery of larger LVs. (c) 2025 International Society for Heart and Lung Transplantation. All rights are reserved, including those for text and data mining, AI training, and similar technologies.