Heart transplantation risk factors
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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.