Characteristics of Patients With Survival Longer Than 20 Years Following Heart Transplantation

Jaramillo, Natalia; Segovia, Javier; Gómez‐Bueno, Manuel; García-Cosío, Dolores; Castedo, Evaristo; Serrano, Santiago; Burgos, R; Montero, Carlos; Ugarte, Juan; Cabeza, Paloma Martínez; Alonso‐Pulpón, Luis

doi:10.1016/j.rec.2013.05.016

Cited by 21 publications

(23 citation statements)

References 12 publications

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“…These results agree with those from the Registry of the International Society for Heart and Lung Transplantation (ISHLT) which reported a 20‐year survival rate of 21.6% and a 27% likelihood of being alive 20 years after transplantation for recipients who survived the first year . To date, only few reports with a follow‐up of more than 20 years after OHT have been published . In the Stanford University experience, 60 (12.5%) patients transplanted between 1968 and 1987 survived 20 years or more and 11 of these long‐term survivors had undergone re‐transplantation .…”

Section: Discussionsupporting

confidence: 86%

“…On the other hand, median survival was slightly longer in the Stanford report than in our series (28.1 vs. 26.5 years), but this is likely due to younger recipients (mean age at transplant: 29 AE 14 vs. 42.9 AE 12.8 years) and donors (mean age: 22 AE 8 vs. 31.5 AE 12.3 years) in the Stanford cohort [7]. Other series reported 24% (12) and 26% (13) survival rates at 20 years in smaller cohorts.…”

Section: Quality-of-life Assessmentcontrasting

confidence: 61%

“…[4]. To date, only few reports with a follow-up of more than 20 years after OHT have been published [7,[12][13][14]. In the Stanford University experience, 60 (12.5%) patients transplanted between 1968 and 1987 survived 20 years or more and 11 of these long-term survivors had undergone re-transplantation [7].…”

Section: Quality-of-life Assessmentmentioning

confidence: 99%

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Clinical outcome and quality of life of patients surviving 20 years or longer after heart transplantation

et al. 2014

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SummaryTo evaluate outcome and quality of life (QoL) in ≥20 years survivors after heart transplantation. Patients surviving ≥20 years with a single graft were retrospectively reviewed. Heterotopic, multiorgan and retransplantations were excluded. QoL was evaluated using the SF-36 survey. Eight hundred and twenty-seven heart transplants were performed from 1981 to 1993, and among these, 131 (16%) patients survived ≥20 years; 98 (75%) were male and mean age at transplant was 43 AE 13 years. Conditional survival in these 20 years survivors was 74.1 AE 4.3% at 23 years and 60.9 AE 5.3% at 25 years (45 deaths, 34%). Forty-four (34%) patients suffered rejection ≥2R. Conditional survival free from rejection ≥2R was 68 AE 4.1% at 5 years and 66.4 AE 4.2% at 10 years. Thirty-five (27%) patients had cardiac allograft vasculopathy (CAV) grade 2-3. Conditional CAV-free survival was 76 AE 3.8% at 20 years and 72.1 AE 4% at 25. Sixty-nine (53%) patients developed malignancy, mostly skin cancers. Conditional malignancy-free survival was 53.5 AE 4.4% at 20 years and 45.2 AE 4.6% at 25 years. At latest follow-up, 24.0 AE 3.0 years after transplantation, mean left ventricular ejection fraction was 62 AE 11% and mean physical and mental scores were 57 AE 23 and 58 AE 21, respectively. Sixteen per cent of heart recipients survived ≥20 years with good ventricular performance and QoL. CAV and malignancies account for late morbidity and mortality.

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Section: Discussionsupporting

confidence: 86%

Section: Quality-of-life Assessmentcontrasting

confidence: 61%

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Clinical outcome and quality of life of patients surviving 20 years or longer after heart transplantation

et al. 2014

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“…These predictors are: non-ischemic cardiomyopathy as the primary diagnosis, younger recipient age, younger donor-graft age and shorter allograft ischemic time; all associated with a better long-term prognosis (3,10,11). The mortality beyond one-year after HTx has remained relatively constant, and Stehlik et al (3) predict that interventions resulting in a reduction of mortal events in the long-term are needed to achieve further improvements in survival after HTx.…”

Section: Physical Capacity As a Prognostic Variablementioning

confidence: 99%

Peak oxygen uptake and self‐reported physical health are strong predictors of long‐term survival after heart transplantation

Yardley

Havik

Grov

et al. 2015

Clinical Transplantation

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Background Peak oxygen uptake (VO2peak) is known as the gold standard measure of cardiopulmonary fitness. We therefore hypothesized that measures of physical health would predict long‐term survival in heart transplant recipients (HTx). Methods This retrospective study investigated survival in two HTx populations; the cardiopulmonary exercise test (CPET) cohort comprised 178 HTx patients who completed a VO2peak test during their annual follow‐up (1990–2003), and the SF‐36 cohort comprised 133 patients who completed a quality of life questionnaire, SF‐36v1 (1998–2000). Results Mean (SD) age in the CPET cohort was 52 (12) yr and 54 (11) yr in the SF‐36 cohort. Mean observation time was, respectively, 11 and 10 yr. Mean (SD) VO2peak was 19.6 (5.3) mL/kg/min, and median (IR) physical function (PF) score was 90 (30). VO2peak and PF scores were both significant predictors in univariate Cox regression. Multiple Cox regression analyses adjusted for other potential predictors showed that VO2peak, age, and cardiac allograft vasculopathy (CAV) were the most important predictors in the CPET cohort, whereas age, PF score, smoking, and CAV were the most important predictors in the SF‐36 cohort. In Kaplan–Meier analysis, VO2peak and PF scores above the median value were related to significant longer survival time. Conclusion Peak oxygen uptake and self‐reported physical health are strong predictors for long‐term survival in HTx recipients. VO2peak is a crucial measurement and should be more frequently used after HTx.

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“…Aliada à presença de outras comorbidades frequentes como dislipidemia (85%) e diabetes mellitus (33%), a necessidade do controle da pressão arterial e dos outros fatores de risco torna-se necessária e com metas terapêuticas e de prevenção semelhantes à população geral, devido ao conhecimento dos seus benefícios (29) .…”

Section: Os Dados Da Internacional Society For Heart and Lung Transplunclassified

Avaliação do índice de rigidez arterial em pacientes transplantados de coração, hipertensos e não hipertensos

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Characteristics of Patients With Survival Longer Than 20 Years Following Heart Transplantation

Cited by 21 publications

References 12 publications

Clinical outcome and quality of life of patients surviving 20 years or longer after heart transplantation

Clinical outcome and quality of life of patients surviving 20 years or longer after heart transplantation

Peak oxygen uptake and self‐reported physical health are strong predictors of long‐term survival after heart transplantation

Avaliação do índice de rigidez arterial em pacientes transplantados de coração, hipertensos e não hipertensos

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