Cor Vasa 2002, 43(2):73-76
Pre-transplant risk factors affecting early mortality following orthotopic heart transplantation
- Centrum kardiovaskulární a transplantační chirurgie, Brno, Česká republika
Aim:
To identify the risk factors of early (30-day) mortality after orthotopic heart transplantation (OHT) with respect to the recipient and donor.
Method:
A retrospective study in 167 patients undergoing OHT, in particular a detailed analysis of data from patients dying within 30 days post-transplant (including their respective donors).
Results:
The identified risk factors of early mortality in deceased recipients included urgency status (p < 0.05), previous heart surgery (p < 0.001), increased pulmonary vascular resistance (p < 0.025), and an older mean age (p < 0.001). A low tissue compatibility was not found to be a significant risk factor.
The risk factors identified with donors included the female gender (p < 0.05) and graft cold ischemia time (p < 0.01). No significant differences were demonstrated in catecholamine-based circulatory support, left ventricular ejection fraction, and cause of death.
Conclusions:
Analysis of early mortality post-OHT revealed that, besides currently intractable conditions such as primary graft dysfunction, hyperacute rejection, or unexpectable sudden death, there are situations which offer room for diagnostic and therapeutic refinement, and where the outcome of costly therapeutic efforts can still be improved.
Keywords: Early mortality; Heart transplantation; Risk factors
Published: February 1, 2002 Show citation