Background: Infection after cardiovascular surgery is multifactorial. We sought to determine whether the anthropometric profile influence the occurrence of infection after isolated coronary artery bypass grafting (CABG). Methods: Between January 2011 and June 2016, 1,777 consecutive adult patients were submitted to isolated coronary artery bypass grafting. Mean age was 61.7 ± 9.8 years and 1,193 (67.1%) were males. Patients were divided into four groups according to the Body Mass Index (BMI) classification: underweight (BMI<18.5 kg/m2: N=17, 0.9%), normal range (BMI 18.5 – 24.99 kg/m2: N=522, 29.4%), overweight (BMI 25 – 29.99 kg/m2: N=796, 44.8%) and obese (>30 kg/m2: N=430, 24.2%). In-hospital outcomes were compared and independent predictors of infection were obtained through multiple Poisson regression with robust variation. Results: Independent predictors of any infection morbidity were female sex (RR 1.47, P=0.002), age > 60 years (RR 1.85, P<0.0001), cardiopulmonary bypass > 120 minutes (RR 1.89, P=0.0007), preoperative myocardial infarction < 30 days (RR 1.37, P=0.01), diabetes mellitus (RR 1.59, P=0.0003), ejection fraction < 48% (RR 2.12, P<0.0001) and blood transfusion (RR 1.55, P=0.0008). Among other variables, obesity, as well as diabetes mellitus, were independent predictors of superficial and deep sternal wound infection. Conclusions: Other factors rather than the anthropometric profile are more important in determining the occurrence of any infection after CABG. However, surgical site infection has occurred more frequently in obese patients. Appropriate patient selection, control of modifiable factors and application of surgical bundles would minimize this important complication.

Background and aim of the study: In developed countries, the shortage of viable donors is the main limiting factor of heart transplantation. The aim of this study is to determine whether the same reality applies to Brazil. Methods: Between January 2012 and December 2014, 299 adult heart donor offers were studied in terms of donor profiles, and reasons of refusal. European donor scoring system was calculated, being high-risk donors defined as >17 points. Donor scoring system used to objectively determine the donor profile and correlate with donor acceptance and post-transplant primary graft dysfunction and recipient survival. Cox proportional hazard model was used in determining predictors of long-term mortality. Results: Rate of donor acceptance and heart transplants performed were 45.8% and 19.3%, respectively. Reasons for refusal were mostly non-medical (53.7%). The majority of donors were classified as high-risk (65.5%). Hearts from high-risk donors did not impact on primary graft dysfunction (14.3% vs 10%, P=0.6), neither on long-term survival (P=0.4 by log-rank test). Recipient’s age greater than 50 years (HR 6.02, CI95% 2.41 – 16.08, P<0.0001) was the only predictor of long-term mortality. Conclusions: Shortage of donors is not the main limiting factor of heart transplantation in Mid-West of Brazil. Non-medical issues represent the main reason of organ discard. Most of the donors were classified as high-risk which indicates that an expanded donor pool is a routine practice in our region, and donor scoring does not seem to influence to proceed with the transplant.