{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:04:51Z","timestamp":1773000291495,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heart transplantation remains the main treatment for end\u2010stage heart failure. The opioid crisis has increased donor availability, including organs from intoxicated individuals, but the impact on outcomes is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA 2020, we searched MEDLINE, Embase, and Web of Science for studies on adult heart transplant recipients with donors exposed to substances like cocaine, heroin, marijuana, tobacco, or opioids. Eligible studies met PICOS criteria, and meta\u2010analyses used a random\u2010effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve retrospective cohorts were included, totaling 189\u00a0935 recipients, 33\u00a0393 of whom received organs from intoxicated donors. The most reported substances were cocaine, alcohol, and tobacco. No significant differences were found in 5\u2010year survival (HR\u00a0=\u00a01.05; CI\u00a0=\u00a00.94\u20131.17), 10\u2010year survival (HR\u00a0=\u00a00.94; CI\u00a0=\u00a00.88\u20131.00), or survival with overdose\u2010related donors (HR\u00a0=\u00a00.96; CI\u00a0=\u00a00.84\u20131.09). Rates of allograft rejection (HR\u00a0=\u00a00.99; CI\u00a0=\u00a00.21\u20130.88) and cardiac allograft vasculopathy (HR\u00a0=\u00a01.02; CI\u00a0=\u00a00.95\u20131.11) were also similar. Subgroup and sensitivity analyses confirmed result consistency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Organs from intoxicated donors do not compromise long\u2010term outcomes and may help address donor shortages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70404","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:29:26Z","timestamp":1764253766000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Intoxicated Donors on Recipient Survival in Cardiac Transplantation: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0274-6001","authenticated-orcid":false,"given":"Leonardo Brito de","family":"Souza","sequence":"first","affiliation":[{"name":"Department of 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Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mateus Paiva Marques","family":"Feitosa","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Fortaleza  Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jefferson Lu\u00eds","family":"Vieira","sequence":"additional","affiliation":[{"name":"Hospital De Messejana Dr. Carlos Alberto Studart  Fortaleza Cear\u00e1 Brazil"},{"name":"Universidade Federal do Cear\u00e1  Fortaleza Cear\u00e1 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