Pre-transplant Patient Characteristics and Early Post-transplant Mortality
Détails
Etat: Public
Version: Après imprimatur
ID Serval
serval:BIB_62E16BB1A287
Type
Mémoire
Sous-type
(Mémoire de) maîtrise (master)
Collection
Publications
Institution
Titre
Pre-transplant Patient Characteristics and Early Post-transplant Mortality
Directeur⸱rice⸱s
HULLIN R.
Détails de l'institution
Université de Lausanne, Faculté de biologie et médecine
Statut éditorial
Acceptée
Date de publication
2015
Langue
anglais
Nombre de pages
25
Résumé
Background:
In 2007, the University Hospital of Lausanne established the multi-disciplinary Heart Transplantation (HTx) team to improve quality of peri-transplant care. Comparison of the period 2000-2007 and 2008-2014 showed a decrease of in-hospital mortality from 22.2 to 16.2% and a reduction of 1-year all cause mortality (ACM) from 25.8% to 18.9% (p=0.612). This study investigates whether decreased mortality early post-transplant is associated with pre-transplant characteristics of HTx recipients.
Methods and Results:
A total of 140 patients were included with HTx recipients operated between the years 2000 to 2007 (n=66) and 2008 to 2014 (n=74). Mean age of all patients was 53.5 years (IQR 47.3- 59.8), 112 males, donor/recipient mismatch was present in 38.3% of patients, length of in- hospital stay was 34 days (IQR 26-61 days); donor age was 41 years (IQR 26-51 years). There was no respective difference between patients operated 2000-2007 and 2008-2014. HTx recipients operated between the years 2008-2014 less often had dilated cardiomyopathy of non-ischemic origin (43.2 vs 63.6%; p=0.024), received more often resynchronization therapy (66.2 vs. 33.3%; p=0.0002), AICD treatment (60.8 vs. 21.2%; p<0.0001), or assist device treatment (24.3 vs. 9.1%; p=0.030). Mean stay on the waiting list was longer (177 vs. 110 days; p=0.04). Baseline hemodynamic data, echocardiographic parameters, cardiovascular risk factors, comorbidity load, and baseline clinical parameters were not different between groups. Diabetes mellitus was a predictor of in-hospital and 1-year ACM in patients operated between 2000 and 2007.
Conclusion:
Characteristics of HTx recipients and donors were not significantly different between HTx recipients operated between the years 2000 to 2007 and 2008 to 2014 suggesting that establishment of a HTx team improved early outcome after HTx.
In 2007, the University Hospital of Lausanne established the multi-disciplinary Heart Transplantation (HTx) team to improve quality of peri-transplant care. Comparison of the period 2000-2007 and 2008-2014 showed a decrease of in-hospital mortality from 22.2 to 16.2% and a reduction of 1-year all cause mortality (ACM) from 25.8% to 18.9% (p=0.612). This study investigates whether decreased mortality early post-transplant is associated with pre-transplant characteristics of HTx recipients.
Methods and Results:
A total of 140 patients were included with HTx recipients operated between the years 2000 to 2007 (n=66) and 2008 to 2014 (n=74). Mean age of all patients was 53.5 years (IQR 47.3- 59.8), 112 males, donor/recipient mismatch was present in 38.3% of patients, length of in- hospital stay was 34 days (IQR 26-61 days); donor age was 41 years (IQR 26-51 years). There was no respective difference between patients operated 2000-2007 and 2008-2014. HTx recipients operated between the years 2008-2014 less often had dilated cardiomyopathy of non-ischemic origin (43.2 vs 63.6%; p=0.024), received more often resynchronization therapy (66.2 vs. 33.3%; p=0.0002), AICD treatment (60.8 vs. 21.2%; p<0.0001), or assist device treatment (24.3 vs. 9.1%; p=0.030). Mean stay on the waiting list was longer (177 vs. 110 days; p=0.04). Baseline hemodynamic data, echocardiographic parameters, cardiovascular risk factors, comorbidity load, and baseline clinical parameters were not different between groups. Diabetes mellitus was a predictor of in-hospital and 1-year ACM in patients operated between 2000 and 2007.
Conclusion:
Characteristics of HTx recipients and donors were not significantly different between HTx recipients operated between the years 2000 to 2007 and 2008 to 2014 suggesting that establishment of a HTx team improved early outcome after HTx.
Mots-clé
Heart transplantation - recipient characteristics - early mortality
Création de la notice
31/08/2016 15:26
Dernière modification de la notice
20/08/2019 15:19