Current protocols for matching donor hearts to recipients foster sex mismatching and heart size disparities, according to a first-of-its kind analysis by physicians at the University of Maryland School of Medicine and the University of Iowa. Matching instead by donor heart size may provide better outcomes for recipients, who already face a scarcity of resources as they await a transplant.
The analysis of 22 years of adult heart transplant data in the U.S., published this week in "JACC: Heart Failure" by the American College of Cardiology, critically re-appraises the current practice of matching donors and recipients by body weight rather than heart size. While two people may weigh the same, their hearts could have vastly different sizes—often requiring a smaller donor heart to strain to do the necessary work. The researchers dubbed this the “Grinch” effect, referring to the Dr. Seuss character whose heart was “two sizes too small.”
The contrast is especially amplified when a match based on body weight doesn’t factor in sex differences.