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
Both the following factors are associated with an increased one-year mortality rate in the recipient.
- Advanced donor age [1]
- prolonged ischemia time
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
- 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.
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
| First 30 days post-transplant | From 1 month to 12 months post-transplant | After 5 years post-transplant |
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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.
- ↑ 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.