Heart transplantation prognosis: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
Factors determining prognosis | Factors determining prognosis | ||
=== Donor factors=== | |||
*Advanced donor age | |||
*prolonged ischemia time | |||
===Recipient factors=== | |||
** 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 with mechanical ventilation or dialysis. | ** 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 with mechanical ventilation or dialysis. | ||
** Best prognosis is seen if the indication for transplant is ischemic and nonischemic cardiomyopathy, whereas patients with a history of congenital heart disease, restrictive cardiomyopathy, and those undergoing retransplantation have worse prognosis. | ** Best prognosis is seen if the indication for transplant is ischemic and nonischemic cardiomyopathy, whereas patients with a history of congenital heart disease, restrictive cardiomyopathy, and those undergoing retransplantation have worse prognosis. | ||
Revision as of 18:36, 5 June 2020
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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
- Advanced donor age
- prolonged ischemia time
Recipient factors
- 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 with mechanical ventilation or dialysis.
- Best prognosis is seen if the indication for transplant is ischemic and nonischemic cardiomyopathy, whereas patients with a history of congenital heart disease, restrictive cardiomyopathy, and those undergoing retransplantation have worse prognosis.
- Younger recipients (below age 55) have an advantage
- Pre-transplant serum creatinine and total bilirubin are linearly related to survival.
Some other risk factors related to the recipient 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. [1]
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, [2]
Causes of Death after Transplantation
The following table outlines the common causes of death in post-cardiac transplant patients
| First 30 days post-transplant | From 1 month to 12 months post-transplant | After 5 years post-transplant |
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References
- ↑ 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. - ↑ Heart Transplant Patient OK After 28 Yrs (September 14, 2006) CBS News. Retrieved December 29, 2006.