Heart transplantation prognosis: Difference between revisions

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===Recipient factors===  
===Recipient factors===  
* Use of total artificial heart as a bridge to transplant or a need for end-organ support with [[mechanical ventilation]] or [[dialysis]]- associated with the greatest one-year mortality was seen with the
* 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>



Revision as of 06:45, 8 June 2020

Heart transplantation Microchapters

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Equitable Distribution of Donor Hearts to those Awaiting Transplantation and the Process of Being Listed for a Transplant

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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D.; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [1]

Prognosis

Factors determining prognosis

Donor factors

Both the following factors are associated with an increased one-year mortality rate in the recipient.

Recipient factors

Some other risk factors are:

  • Use of Amiodarone pretransplantation
  • Prior cardiac surgery
  • Transplantation of a female heart into a male or female recipient

Post-transplant survival has improved over time. The median survival after adult heart transplants performed between 2002 and 2009 is 12.5 years, which extends to 14.8 years among 1-year survivors. [3]

Tony Huesman was the world's longest-living heart transplant patient, having survived for 28 years with a transplanted heart. Huesman received a heart transplant in 1978 at Stanford University under American heart transplant pioneer Dr. Norman Shumway, [4]

Causes of Death after Transplantation

The following table outlines the common causes of death in post-cardiac transplant patients [5]


First 30 days post-transplant From 1 month to 12 months post-transplant After 5 years post-transplant
  • Cardiac allograft vasculopathy (CAV)
  • Late graft failure (Both together accounting for 33% of deaths)
  • Malignancies (23%)
  • Non-CMV infections (11%)

References

  1. 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.
  2. 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.
  3. Khush KK, Cherikh WS, Chambers DC, Harhay MO, Hayes D, Hsich E; et al. (2019). "The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult heart transplantation report - 2019; focus theme: Donor and recipient size match". J Heart Lung Transplant. 38 (10): 1056–1066. doi:10.1016/j.healun.2019.08.004. PMC 6816343 Check |pmc= value (help). PMID 31548031.
  4. Heart Transplant Patient OK After 28 Yrs (September 14, 2006) CBS News. Retrieved December 29, 2006.
  5. Montoya, Jose G.; Giraldo, Luis F.; Efron, Bradley; Stinson, Edward B.; Gamberg, Pat; Hunt, Sharon; Giannetti, Nadia; Miller, Joan; Remington, Jack S. (2001). "Infectious Complications among 620 Consecutive Heart Transplant Patients at Stanford University Medical Center". Clinical Infectious Diseases. 33 (5): 629–640. doi:10.1086/322733. ISSN 1058-4838.


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