Who gets a second heart? A current picture of cardiac retransplantation.
Détails
ID Serval
serval:BIB_B4CA4901BEEB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Who gets a second heart? A current picture of cardiac retransplantation.
Périodique
Transplantation proceedings
ISSN
1873-2623 (Electronic)
ISSN-L
0041-1345
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
46
Numéro
1
Pages
202-207
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
Heart retransplantation (HRT) accounts for 2.6% of heart transplantation (HT) indications. We performed a retrospective analysis of our recent HRT experience.
From January 2000 to June 2012, 820 HTs were performed; 798 (97.3%) were primary HTs and 21 (2.5%) 2nd HTs. Indications for HRT included: 57% cardiac allograft vasculopathy, 33% nonspecific graft failure, 5% primary graft failure (PGF), and 5% refractory acute rejection. The primary outcome was overall survival. Our results were compared with the most representative publications reporting HRT experiences before January 2000.
Mean age at HRT was 39.9 ± 14.3 years, and there was a predominance of male patients (62%). Overall mortality was 52%; 30-day mortality was 19%. Eight patients (38%) developed PGF after HRT and 3 of them (38%) died within 30 days. Overall actuarial survivals at 1 month and 1, 3, and 5 years were 81.0%, 70.8%, 59.9%, and 53.3%, respectively. No significant risk factors for mortality could be identified.
We observed improved short- and medium-term survival after HRT. This finding is probably related to changing recipient profiles, with less patients being retransplanted for PGF and more patients undergoing late retransplantation. Higher rates of PGF after HRT reflect our efforts to broaden the allograft pool by using marginal donors.
From January 2000 to June 2012, 820 HTs were performed; 798 (97.3%) were primary HTs and 21 (2.5%) 2nd HTs. Indications for HRT included: 57% cardiac allograft vasculopathy, 33% nonspecific graft failure, 5% primary graft failure (PGF), and 5% refractory acute rejection. The primary outcome was overall survival. Our results were compared with the most representative publications reporting HRT experiences before January 2000.
Mean age at HRT was 39.9 ± 14.3 years, and there was a predominance of male patients (62%). Overall mortality was 52%; 30-day mortality was 19%. Eight patients (38%) developed PGF after HRT and 3 of them (38%) died within 30 days. Overall actuarial survivals at 1 month and 1, 3, and 5 years were 81.0%, 70.8%, 59.9%, and 53.3%, respectively. No significant risk factors for mortality could be identified.
We observed improved short- and medium-term survival after HRT. This finding is probably related to changing recipient profiles, with less patients being retransplanted for PGF and more patients undergoing late retransplantation. Higher rates of PGF after HRT reflect our efforts to broaden the allograft pool by using marginal donors.
Mots-clé
Adolescent, Adult, Aged, Allografts, Child, Child, Preschool, Female, Follow-Up Studies, Graft Rejection, Graft Survival, Heart Failure/surgery, Heart Transplantation/statistics & numerical data, Humans, Immunosuppressive Agents/therapeutic use, Male, Middle Aged, Postoperative Complications, Proportional Hazards Models, Reoperation/statistics & numerical data, Retrospective Studies, Risk Factors, Tissue Donors, Treatment Outcome, Young Adult
Pubmed
Web of science
Création de la notice
28/03/2019 18:40
Dernière modification de la notice
20/08/2019 16:23