Heart transplantation prognosis
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Heart transplantation Microchapters |
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Heart transplantation prognosis On the Web |
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American Roentgen Ray Society Images of Heart transplantation prognosis |
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Risk calculators and risk factors for Heart transplantation prognosis |
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]
As of 2006, Tony Huesman is the world's longest living heart transplant patient, having survived for 28 years with a transplanted heart. Huesman received a heart in 1978 at the age of 20 after viral pneumonia severely weakened his heart. The operation was performed at Stanford University under American heart transplant pioneer Dr. Norman Shumway, who continued to perform the operation in the U.S. after others abandoned it due to poor results. [2]
Causes of Death after Transplantation
The following table outlines the common causes of death in post cardiac transplant patients [3]:
| 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.
- ↑ Taylor DO, Stehlik J, Edwards LB, Aurora P, Christie JD, Dobbels F; et al. (2009). "Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult Heart Transplant Report-2009". J Heart Lung Transplant. 28 (10): 1007–22. doi:10.1016/j.healun.2009.08.014. PMID 19782283.