Pretransplantation risk factors for death after heart transplantation: the Henri Mondor experience.

Details

Serval ID
serval:BIB_C6311488FE3C
Type
Article: article from journal or magazin.
Collection
Publications
Title
Pretransplantation risk factors for death after heart transplantation: the Henri Mondor experience.
Journal
The Journal of heart and lung transplantation
Author(s)
Kirsch M., Baufreton C., Naftel D.C., Benvenuti C., Loisance D.Y.
ISSN
1053-2498 (Print)
ISSN-L
1053-2498
Publication state
Published
Issued date
03/1998
Peer-reviewed
Oui
Volume
17
Number
3
Pages
268-277
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Risk factors for death after primary heart transplantation were identified by analyzing our total experience with 234 patients who underwent transplantation at our institution from May 28, 1979, to May 27, 1996.
There were 205 male and 29 female patients. Mean recipient age was 48.5+/-10.9 years (standard deviation). Recipient diagnosis included ischemic cardiomyopathy in 103 (44%), idiopathic cardiomyopathy in 98 (42%), valvular heart disease in 17 (7%), congenital heart disease in 4 (2%), and other diagnoses in 12 (5%) patients. Donor age was 32+/-10.2 years. Graft ischemic time was 138.1+/-51.8 minutes. The operative mortality rate was 23.5%. Actuarial survival estimates for all patients at 1, 5, and 10 years were 62%, 50%, and 44%, respectively. The three most common causes of death (both early and late) after primary heart transplantation were infection (27.4%), acute rejection (18.9%), and early graft failure (17.9%). Multivariate logistic regression analysis identified older recipient age (p = 0.007), higher preoperative pulmonary vascular resistance (p = 0.01), recipient preoperative hepatic insufficiency (p = 0.001), and gender mismatch (p = 0.02) as independent predictors of early death (within 3 months of the procedure). Multivariate proportional hazard regression analysis revealed that recipient idiopathic cardiomyopathy (p = 0.02) and recipient preoperative liver failure (p = 0.01) were independent risk factors for late death (after 3 months).
These results underscore the importance of adequate recipient selection and recipient/donor matching for short- and long-term survival after primary heart transplantation.
Keywords
Adolescent, Adult, Aged, Female, Graft Rejection, Heart Transplantation/mortality, Humans, Male, Middle Aged, Multivariate Analysis, Postoperative Complications/mortality, Risk Factors, Survival Analysis, Vascular Resistance
Pubmed
Web of science
Create date
30/03/2019 17:14
Last modification date
20/08/2019 15:41
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