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| Main Authors: | , , , , |
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| Format: | Artículo Open Access |
| Published: |
Wiley
2025
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| Online Access: | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70130 |
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- Type A Aortic Dissection Following Abdominal Solid Organ Transplantation: Population‐Level Outcomes in the United States Yunda Wang Joy Mohnot Kanhua Yin Nikola Dobrilovic Yong Zhan Clinical Transplantation ABSTRACTBackgroundThis study aims to analyze the patient characteristics, clinical outcomes, and contemporary trends concerning type A aortic dissection (TAAD) in previous recipients of abdominal solid organ transplantation (ASOT) in the United States.MethodsThe National Inpatient Sample was queried to identify all patients aged ≥18 with TAAD and a history of ASOT (TAAD‐ASOT) between 2002 and 2015Q3 using ICD‐9 diagnosis and procedure codes. Baseline characteristics and in‐hospital outcomes were compared between TAAD‐ASOT patients and TAAD patients without a history of ASOT (TAAD‐non‐ASOT).ResultsWe identified a weighted total of 71 061 TAAD patients. Among them, 346 (0.49%) were ASOT recipients; of these, 318 (91.9%) were kidney transplant recipients, and 28 (8.1%) were liver transplant recipients. There is an increasing trend in the incidence of TAAD among ASOT recipients over the study period (p‐trend < 0.001). Compared to TAAD‐non‐ASOT patients, TAAD‐ASOT patients were younger (54.7 vs. 60.7 years, p < 0.001), less likely to be White (53.8% vs. 69.1%, p = 0.008), and associated with a higher Charlson Comorbidity Index (3.79 vs. 2.26, p < 0.001). TAAD‐ASOT patients also exhibited significantly higher in‐hospital mortality (27.4% vs. 17.8%, p = 0.03) and a greater risk of renal complications (53.5% vs. 29.7%, p < 0.001). Multivariable analysis indicated that a history of ASOT was independently associated with an increased in‐hospital mortality rate in TAAD patients (adjusted odds ratio = 1.83, 95% CI = 1.01–3.31, p = 0.04).ConclusionsTAAD‐ASOT patients were younger but presented a higher comorbidity burden, an elevated in‐hospital mortality rate, and an increased risk of postoperative complications compared to TAAD‐non‐ASOT patients. The rising incidence and unfavorable outcomes emphasize the need for future preventative measures and enhancements in surgical outcomes. 10.1111/ctr.70130 http://onlinelibrary.wiley.com/termsAndConditions#vor