{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:59:17Z","timestamp":1776254357730,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As COVID\u201019 becomes endemic, evaluating COVID\u201019+ donors for heart transplantation (HT) remains important. We assessed long\u2010term outcomes using national data and propensity\u2010matched analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All adults (&gt;18 years) undergoing HT between 4\/2020 and 9\/2024 were identified in the UNOS database. They were stratified into COVID\u201019+ versus \u2013, defined by either a positive nucleic acid or antigen test within 7 days of HT. Groups were then 3:1 nearest propensity score matched. Survival was estimated by the Kaplan\u2013Meier method. Mortality risk was assessed using Cox regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 879 recipients of COVID\u201019\u2013 hearts were matched with 293 recipients of COVID\u201019+ hearts. We found no significant differences in 3\u2010year landmark survival between cohorts (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.23). Rates of acute rejection (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.15), length of hospital stay (LOS) (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &gt;\u00a00.9), and postoperative stroke (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.53) did not differ significantly between groups. However, dialysis (17%\u00a0vs. 12%,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.04) and primary graft dysfunction rates at 24\u2010h post\u2010HT were significantly higher in COVID\u201019+ heart recipients (5.5%\u00a0vs. 1.8%,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.01). Donor COVID\u201019+ status was not significantly associated with mortality risk (HR 1.01,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.66). COVID\u201019+ donor HTs in recent years (2022\u20132024) were associated with decreased mortality risk (HR 0.82,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.02), rates of acute rejection (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.001), LOS (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.01), and dialysis (18%\u00a0vs. 8.9%,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>COVID\u201019+ hearts demonstrate adequate long\u2010term outcomes, particularly in recent years. Future studies should assess the impact of donor vaccination to optimize survival benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70439","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:33:03Z","timestamp":1768383183000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evolving Long\u2010Term Outcomes of Heart Transplantation Using COVID\u201019 Positive Donors"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4556-1931","authenticated-orcid":false,"given":"Ye In Christopher","family":"Kwon","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery Department of Surgery Pauley Heart Center School of Medicine Virginia Commonwealth University  Richmond Virginia 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