Role of positive donor blood culture in the development of infectious complications in heart transplant recipients during the early postoperative period

The aim of the study was to assess the likelihood of infectious complications (IC) in heart transplant (HTx) recipients receiving grafts from donors with a positive blood culture, as well as to evaluate the microbiological status of donors and the levels of inflammatory biomarkers and immunoglobulins. The study is relevant due to the need to improve heart transplantation safety and minimize the risk of IC, which remain one of the leading causes of postoperative complications  and mortality in the early postoperative period. 

A single-center retrospective study was conducted on 43 HTx procedures performed in 2024 at the Republican Scientific and Practical Center “Cardiology.” Donors and recipients were divided into two groups according to the results of donor blood bacteriological testing. The analysis included blood cultures for sterility, cultures from central venous catheter (CVC) samples, and left atrial tissue of donor hearts, as well as the determination of C-reactive protein, procalcitonin, and immunoglobu- lin levels.

According to the obtained data, a positive donor blood culture was not associated with an increased risk of IC in recipients during the early postoperative period. No significant association was found between positive CVC cultures and donor bacteremia, nor between positive donor blood cultures and the detection of microorganisms in donor heart tissue. The most frequently identified microorganisms were S. epidermidis and A. baumannii. Donors with positive blood cultures exhibited  significantly higher IgA levels compared to those with negative blood cultures, while other inflammatory markers and immuno- globulins showed no statistically significant differences. The findings justify the need to expand the sample size and further investigate the role of microbiological and immunological factors in the development of IC in heart transplant recipients.

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