Heart transplantation risk factors: Difference between revisions
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{{CMG}}; {{AE}} | {{CMG}}; {{AE}} | ||
==Overview== | ==Overview== | ||
There are no established risk factors that lead to cardiac transplantation. | There are no established risk factors that lead to cardiac transplantation. The prognosis of the patient post-transplantation depends on various donor and recipient factors. | ||
==Risk Factors== | ==Risk Factors== | ||
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Risk factors for poor outcome post-transplantation can be due to donor-specific characteristics, recipient-specific characteristics, and risk factors due to interactions between the donor and recipient. | Risk factors for poor outcome post-transplantation can be due to donor-specific characteristics, recipient-specific characteristics, and risk factors due to interactions between the donor and recipient. | ||
=== Donor factors=== | ===Common risk factors=== | ||
==== Donor factors==== | |||
Both the following factors are associated with an increased one-year mortality rate in the recipient. | Both the following factors are associated with an increased one-year mortality rate in the recipient. | ||
*Advanced donor age <ref name="PotapovLoebe1999">{{cite journal|last1=Potapov|first1=Evgenij V.|last2=Loebe|first2=Matthias|last3=H??bler|first3=Michael|last4=Musci|first4=Michele|last5=Hummel|first5=Manfred|last6=Weng|first6=Yu-guo|last7=Hetzer|first7=Roland|title=MEDIUM-TERM RESULTS OF HEART TRANSPLANTATION USING DONORS OVER 63 YEARS OF AGE1|journal=Transplantation|volume=68|issue=12|year=1999|pages=1834–1838|issn=0041-1337|doi=10.1097/00007890-199912270-00002}}</ref> | *Advanced donor age <ref name="PotapovLoebe1999">{{cite journal|last1=Potapov|first1=Evgenij V.|last2=Loebe|first2=Matthias|last3=H??bler|first3=Michael|last4=Musci|first4=Michele|last5=Hummel|first5=Manfred|last6=Weng|first6=Yu-guo|last7=Hetzer|first7=Roland|title=MEDIUM-TERM RESULTS OF HEART TRANSPLANTATION USING DONORS OVER 63 YEARS OF AGE1|journal=Transplantation|volume=68|issue=12|year=1999|pages=1834–1838|issn=0041-1337|doi=10.1097/00007890-199912270-00002}}</ref> | ||
*Prolonged [[ischemia]] time | *Prolonged [[ischemia]] time | ||
===Recipient factors=== | ====Recipient factors==== | ||
* Use of total artificial heart as a bridge to transplant or a need for end-organ support in the form of [[mechanical ventilation]] or [[dialysis]]- associated with the greatest one-year mortality | * Use of total artificial heart as a bridge to transplant or a need for end-organ support in the form of [[mechanical ventilation]] or [[dialysis]]- associated with the greatest one-year mortality | ||
* Best prognosis is seen if the indication for transplant is [[ischemic]] and [[nonischemic cardiomyopathy]] <ref name="KhushCherikh2018">{{cite journal|last1=Khush|first1=Kiran K.|last2=Cherikh|first2=Wida S.|last3=Chambers|first3=Daniel C.|last4=Goldfarb|first4=Samuel|last5=Hayes|first5=Don|last6=Kucheryavaya|first6=Anna Y.|last7=Levvey|first7=Bronwyn J.|last8=Meiser|first8=Bruno|last9=Rossano|first9=Joseph W.|last10=Stehlik|first10=Josef|title=The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-fifth Adult Heart Transplantation Report—2018; Focus Theme: Multiorgan Transplantation|journal=The Journal of Heart and Lung Transplantation|volume=37|issue=10|year=2018|pages=1155–1168|issn=10532498|doi=10.1016/j.healun.2018.07.022}}</ref> | * Best prognosis is seen if the indication for transplant is [[ischemic]] and [[nonischemic cardiomyopathy]] <ref name="KhushCherikh2018">{{cite journal|last1=Khush|first1=Kiran K.|last2=Cherikh|first2=Wida S.|last3=Chambers|first3=Daniel C.|last4=Goldfarb|first4=Samuel|last5=Hayes|first5=Don|last6=Kucheryavaya|first6=Anna Y.|last7=Levvey|first7=Bronwyn J.|last8=Meiser|first8=Bruno|last9=Rossano|first9=Joseph W.|last10=Stehlik|first10=Josef|title=The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-fifth Adult Heart Transplantation Report—2018; Focus Theme: Multiorgan Transplantation|journal=The Journal of Heart and Lung Transplantation|volume=37|issue=10|year=2018|pages=1155–1168|issn=10532498|doi=10.1016/j.healun.2018.07.022}}</ref> | ||
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* Pre-transplant serum [[creatinine]] and total [[bilirubin]] are linearly related to survival. | * Pre-transplant serum [[creatinine]] and total [[bilirubin]] are linearly related to survival. | ||
===Less common risk factors=== | |||
* Use of [[Amiodarone]] pretransplantation | |||
* Hypertension | * Use of [[Amiodarone]] pretransplantation <ref name="pmid27520780">{{cite journal| author=Cooper LB, Mentz RJ, Edwards LB, Wilk AR, Rogers JG, Patel CB | display-authors=etal| title=Amiodarone use in patients listed for heart transplant is associated with increased 1-year post-transplant mortality. | journal=J Heart Lung Transplant | year= 2017 | volume= 36 | issue= 2 | pages= 202-210 | pmid=27520780 | doi=10.1016/j.healun.2016.07.009 | pmc=5241253 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27520780 }} </ref> | ||
* Hypercholesterolemia | *[[Hypertension]] | ||
* Diabetes | *[[Hypercholesterolemia]] <ref name="pmid22308287">{{cite journal| author=Singh TP, Almond CS, Semigran MJ, Piercey G, Gauvreau K| title=Risk prediction for early in-hospital mortality following heart transplantation in the United States. | journal=Circ Heart Fail | year= 2012 | volume= 5 | issue= 2 | pages= 259-66 | pmid=22308287 | doi=10.1161/CIRCHEARTFAILURE.111.965996 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22308287 }} </ref> <ref name="pmid2361019">{{cite journal| author=Radovancevic B, Poindexter S, Birovljev S, Velebit V, McAllister HA, Duncan JM | display-authors=etal| title=Risk factors for development of accelerated coronary artery disease in cardiac transplant recipients. | journal=Eur J Cardiothorac Surg | year= 1990 | volume= 4 | issue= 6 | pages= 309-12; discussion 313 | pmid=2361019 | doi=10.1016/1010-7940(90)90207-g | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2361019 }} </ref> | ||
* Renal insufficiency | *[[Diabetes]] | ||
* Use of specific immunosuppressive regimen | *[[Renal insufficiency]] | ||
* Elevated body mass index | * Use of specific [[Immunosuppression|immunosuppressive]] regimen | ||
* Tobacco use | * Elevated [[body mass index]] | ||
* Obesity | *[[Tobacco]] use | ||
*[[Obesity]] | |||
* Early post-transplant complications | * Early post-transplant complications | ||
* Prior cardiac surgery | * Prior [[cardiac surgery]] | ||
* Transplantation of a female heart into a male or female recipient | *[[Transplantation]] of a female heart into a male or female recipient <ref name="pmid9456101">{{cite journal| author=Prendergast TW, Furukawa S, Beyer AJ, Browne BJ, Eisen HJ, Jeevanandam V| title=The role of gender in heart transplantation. | journal=Ann Thorac Surg | year= 1998 | volume= 65 | issue= 1 | pages= 88-94 | pmid=9456101 | doi=10.1016/s0003-4975(97)01105-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9456101 }} </ref> | ||
==References== | ==References== | ||
Latest revision as of 20:08, 15 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
There are no established risk factors that lead to cardiac transplantation. The prognosis of the patient post-transplantation depends on various donor and recipient factors.
Risk Factors
Risk factors for poor outcome post-transplantation can be due to donor-specific characteristics, recipient-specific characteristics, and risk factors due to interactions between the donor and recipient.
Common risk factors
Donor factors
Both the following factors are associated with an increased one-year mortality rate in the recipient.
Recipient factors
- Use of total artificial heart as a bridge to transplant or a need for end-organ support in the form of mechanical ventilation or dialysis- associated with the greatest one-year mortality
- Best prognosis is seen if the indication for transplant is ischemic and nonischemic cardiomyopathy [2]
- Patients with a history of congenital heart disease, restrictive cardiomyopathy, and those undergoing retransplantation have a worse prognosis.
- Younger recipients (below age 55) have an advantage
- Pre-transplant serum creatinine and total bilirubin are linearly related to survival.
Less common risk factors
- Use of Amiodarone pretransplantation [3]
- Hypertension
- Hypercholesterolemia [4] [5]
- Diabetes
- Renal insufficiency
- Use of specific immunosuppressive regimen
- Elevated body mass index
- Tobacco use
- Obesity
- Early post-transplant complications
- Prior cardiac surgery
- Transplantation of a female heart into a male or female recipient [6]
References
- ↑ Potapov, Evgenij V.; Loebe, Matthias; H??bler, Michael; Musci, Michele; Hummel, Manfred; Weng, Yu-guo; Hetzer, Roland (1999). "MEDIUM-TERM RESULTS OF HEART TRANSPLANTATION USING DONORS OVER 63 YEARS OF AGE1". Transplantation. 68 (12): 1834–1838. doi:10.1097/00007890-199912270-00002. ISSN 0041-1337.
- ↑ Khush, Kiran K.; Cherikh, Wida S.; Chambers, Daniel C.; Goldfarb, Samuel; Hayes, Don; Kucheryavaya, Anna Y.; Levvey, Bronwyn J.; Meiser, Bruno; Rossano, Joseph W.; Stehlik, Josef (2018). "The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-fifth Adult Heart Transplantation Report—2018; Focus Theme: Multiorgan Transplantation". The Journal of Heart and Lung Transplantation. 37 (10): 1155–1168. doi:10.1016/j.healun.2018.07.022. ISSN 1053-2498.
- ↑ Cooper LB, Mentz RJ, Edwards LB, Wilk AR, Rogers JG, Patel CB; et al. (2017). "Amiodarone use in patients listed for heart transplant is associated with increased 1-year post-transplant mortality". J Heart Lung Transplant. 36 (2): 202–210. doi:10.1016/j.healun.2016.07.009. PMC 5241253. PMID 27520780.
- ↑ Singh TP, Almond CS, Semigran MJ, Piercey G, Gauvreau K (2012). "Risk prediction for early in-hospital mortality following heart transplantation in the United States". Circ Heart Fail. 5 (2): 259–66. doi:10.1161/CIRCHEARTFAILURE.111.965996. PMID 22308287.
- ↑ Radovancevic B, Poindexter S, Birovljev S, Velebit V, McAllister HA, Duncan JM; et al. (1990). "Risk factors for development of accelerated coronary artery disease in cardiac transplant recipients". Eur J Cardiothorac Surg. 4 (6): 309–12, discussion 313. doi:10.1016/1010-7940(90)90207-g. PMID 2361019.
- ↑ Prendergast TW, Furukawa S, Beyer AJ, Browne BJ, Eisen HJ, Jeevanandam V (1998). "The role of gender in heart transplantation". Ann Thorac Surg. 65 (1): 88–94. doi:10.1016/s0003-4975(97)01105-3. PMID 9456101.