Results of heart transplantation in the urgent recipient - who should be transplanted?
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| Format: | Artículo científico |
| Sprache: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2014
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| _version_ | 1876443727404204032 |
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| author | David Prieto |
| author_facet | David Prieto |
| contents | Results of heart transplantation in the urgent recipient - who should be transplanted? David Prieto Pedro Correia Pedro Antunes Manuel Batista Manuel J. Antunes Medicina Post Thoracic Surgery Heart Transplantation operative Complications Survival (Public Health) Objective: To evaluate immediate and long-term results of cardiac transplantation at two different levels of urgency. Methods: From November 2003 to December 2012, 228 pa - tients underwent cardiac transplantation. Children and patients in cardiogenic shock were excluded from the study. From the final group (n=212), 58 patients (27%) were hospitalized under inotropic support (Group A), while 154 (73%) were awaiting transplantation at home (Group B). Patients in Group A were younger (52.0±11.3 vs. 55.2±10.4 years, P =0.050) and had shorter waiting times (29.4±43.8 vs. 48.8±45.2 days; P =0.006). No differ - ence was found for sex or other comorbidities. Haemoglobin was lower and creatinine higher in Group A. The characteristics of the donors were similar. Follow-up was 4.5±2.7 years. Results: No differences were found in time of ischemia (89.1±37.0 vs. 91.5±34.5 min, P =0.660) or inotropic support (13.8% vs. 11.0%, P =0.579), neither in the incidence of cellular or humoral rejection and of cardiac allograft vasculopathy. De novo diabetes de novo in the first year was slightly higher in Group A (15.5% vs. 11.7%, P =0.456), and these patients were at increased risk of serious infection (22.4% vs. 12.3%, P =0.068). Hospital mortality was similar (3.4% vs. 4.5%, P =0.724), as well as long-term survival (7.8±0.5 vs. 7.4±0.3 years). Conclusions: The results obtained in patients hospitalized under inotropic support were similar to those of patients awaiting transplantation at home. Allocation of donors to the first group does not seem to compromise the benefit of transplantation. These results may not be extensible to more critical patients. 2014 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941894014 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.3 Vol.29 |
| format | Artículo científico |
| id | redalyc_398941894014 |
| institution | Redalyc |
| language | en |
| publishDate | 2014 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Results of heart transplantation in the urgent recipient - who should be transplanted? David Prieto Medicina Post Thoracic Surgery Heart Transplantation operative Complications Survival (Public Health) Results of heart transplantation in the urgent recipient - who should be transplanted? David Prieto Pedro Correia Pedro Antunes Manuel Batista Manuel J. Antunes Medicina Post Thoracic Surgery Heart Transplantation operative Complications Survival (Public Health) Objective: To evaluate immediate and long-term results of cardiac transplantation at two different levels of urgency. Methods: From November 2003 to December 2012, 228 pa - tients underwent cardiac transplantation. Children and patients in cardiogenic shock were excluded from the study. From the final group (n=212), 58 patients (27%) were hospitalized under inotropic support (Group A), while 154 (73%) were awaiting transplantation at home (Group B). Patients in Group A were younger (52.0±11.3 vs. 55.2±10.4 years, P =0.050) and had shorter waiting times (29.4±43.8 vs. 48.8±45.2 days; P =0.006). No differ - ence was found for sex or other comorbidities. Haemoglobin was lower and creatinine higher in Group A. The characteristics of the donors were similar. Follow-up was 4.5±2.7 years. Results: No differences were found in time of ischemia (89.1±37.0 vs. 91.5±34.5 min, P =0.660) or inotropic support (13.8% vs. 11.0%, P =0.579), neither in the incidence of cellular or humoral rejection and of cardiac allograft vasculopathy. De novo diabetes de novo in the first year was slightly higher in Group A (15.5% vs. 11.7%, P =0.456), and these patients were at increased risk of serious infection (22.4% vs. 12.3%, P =0.068). Hospital mortality was similar (3.4% vs. 4.5%, P =0.724), as well as long-term survival (7.8±0.5 vs. 7.4±0.3 years). Conclusions: The results obtained in patients hospitalized under inotropic support were similar to those of patients awaiting transplantation at home. Allocation of donors to the first group does not seem to compromise the benefit of transplantation. These results may not be extensible to more critical patients. 2014 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941894014 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.3 Vol.29 |
| title | Results of heart transplantation in the urgent recipient - who should be transplanted? |
| topic | Medicina Post Thoracic Surgery Heart Transplantation operative Complications Survival (Public Health) |
| url | https://www.redalyc.org/articulo.oa?id=398941894014 |