Pre-transplant Patient Characteristics and Early Post-transplant Mortality

Details

Ressource 1Download: BIB_62E16BB1A287.P001.pdf (573.26 [Ko])
State: Public
Version: After imprimatur
Serval ID
serval:BIB_62E16BB1A287
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Pre-transplant Patient Characteristics and Early Post-transplant Mortality
Author(s)
SCHMIDHAUSER M.
Director(s)
HULLIN R.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2015
Language
english
Number of pages
25
Abstract
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.
Keywords
Heart transplantation - recipient characteristics - early mortality
Create date
31/08/2016 14:26
Last modification date
20/08/2019 14:19
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