Patología del trasplante cardiaco en el Perú: Experiencia con 61 casos en un centro de referencia nacional

Aguilar, Cristian; Alarco, Walter; Soplopuco, Franz; Morón, Julio; Lescano, Miguel; Morales, Jorge; Gálvez, David A.

doi:10.17843/rpmesp.2018.352.3264

Cited by 5 publications

(13 citation statements)

References 16 publications

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“…Like ISHLT reports, our main indications were idiopathic DCM in 66.3% of HTx and ischaemic cardiomyopathy in 18.1% (21). Although Chagas disease continues to be a Latin American public health problem, we have no indications for HTx due to Chagas cardiomyopathy (7,22). We consider that this is related to the underreporting of cases, and this local factor should be reevaluated since we are still a Chagas endemic country (23).…”

Section: Discussionmentioning

confidence: 61%

“…Given this development, some Latin American countries have reported their results, showing that HTx programs are feasible in developing countries (6-8). Approximately nine transplants were performed in Peru during the 1990s in different national centers in Lima (1,7). Although this initiative was bringing unhurried but worthy results, it declined due to the lack of funding and political interest (1).…”

Section: Discussionmentioning

confidence: 99%

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Heart transplantation at the Peruvian National Heart Institute: One-decade single-center experience

Pinto‐Salinas

Morón-Castro

Chavarri‐Velarde

et al. 2021

Preprint

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Background: Heart transplantations are ideal for most patients with end-stage heart failure refractory to medical treatment. The transplantation program at the Peruvian National Heart Institute started with a 10-year-continuity in 2010. Objective: To report the results of a 10-year heart transplantation experience at the Peruvian National Heart Institute. Methods: We studied 83 patients who underwent orthotopic heart transplantation at a single center between January 2010 and December 2019. The recipients’ profiles and survival were analyzed according to sex and age group, ensuring the information’s confidentiality. Results: The recipients’ mean age was 41.2 ± 17 years, 88% were adult, and 68.7% were male. The main indications for transplantation were idiopathic dilated cardiomyopathy. 85.5% of recipients were clinically categorized as INTERMACS Profile 1 to 3 before transplantation. There was a significant difference between sexes regarding the preoperative left ventricular ejection fraction and between age groups regarding the waiting time. The average ischemia time was 3.1 hours, operating time was 6.1 hours, cardiopulmonary bypass time was 3 hours, and aortic cross-clamp time was 1.7 hours. The principal early postoperative complications were hematological disorders and acute kidney failure. The principal late ones were kidney failure and severe anemia. The postoperative mortality was 15.9%, and the principal causes were infection and then acute rejection. The survival at one, five, and ten years was 87.5%, 79.8%, and 79.8%, respectively. The survival results were not influenced by sex or age group. Conclusion: Our patients’ postoperative complications, mortality, and survival rates coincided with those reported by the ISHLT registry.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Heart transplantation at the Peruvian National Heart Institute: One-decade single-center experience

Pinto‐Salinas

Morón-Castro

Chavarri‐Velarde

et al. 2021

Preprint

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“…La media de edad en el registro español fue de 49,2±17,7 años y en el registro de ISHLT la mediana es de 55 (25-68) años (8) ; en Sudamérica, la mediana de edad en Brasil fue 48 años (38-56) (7) y en Argentina fue de 50±13 años (9) ; nuestra mediana de edad fue de 41 (28-56,2), la cual se mantiene en el tiempo, ya que Aguilar et al (10) encontraron una media de 40,1 años. En nuestro estudio se encontró que el grupo sanguíneo del receptor más común fue el grupo O con 70,9% de los pacientes, a diferencia de los hallazgos del ISHLT en donde el grupo sanguíneo predominante fue el A (8) .…”

Section: Discussionunclassified

“…La etiología subyacente más frecuente en nuestro estudio fue la cardiomiopatía dilatada, con una diferencia notable frente a la cardiopatía isquémica, corroborando lo hallado por Aguilar et al (10) donde el 50,8% de los pacientes tenía diagnóstico de cardiomiopatía dilatada. Esto difiere con los hallazgos argentinos Figura 3.…”

Section: Discussionunclassified

Características epidemiológicas de receptores de trasplante cardiaco en el Perú, 2010-2020

Lecca¹,

Palacios²,

León³

et al. 2021

Arch Peru Cardiol Cir Cardiovasc

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Objetivo. Evaluar las características epidemiológicas, clínicas, quirúrgicas, patológicas y desenlaces en el seguimiento de los pacientes receptores de trasplante cardiaco en el Instituto Nacional Cardiovascular durante 2010-2020. Materiales y métodos. Estudio retrospectivo descriptivo de pacientes sometidos a trasplante cardiaco en un centro de referencia nacional, se describen las características clínicas, quirúrgicas, de laboratorio, de patología y la supervivencia de los pacientes hasta los 10 años de seguimiento. Resultados. Ochenta y seis pacientes fueron trasplantados en 10 años, la mediana de edad fue de 41 años (RIQ 28-56), con predominancia de varones (66,3%). Las tres primeras causas de indicación de trasplante cardiaco fueron: cardiomiopatía dilatada (48,9%), cardiopatía isquémica (17,4%) y miocarditis (6,9%). El tiempo de isquemia total fue de 160 min (RIQ 129,7-233,5). La sobrevida al año, cinco y diez años fue de 84,8%, 73,6% y 65,7%, respectivamente. La principal causa de muerte fue la infecciosa (39,1%) y de origen desconocido (26%). Conclusiones. La principal etiología de la insuficiencia cardiaca en el receptor de trasplante cardiaco en el Perú, en los últimos años, fue la cardiomiopatía dilatada no isquémica. Se observa que la tasa de sobrevida fue similar a la de registros internacionales; sin embargo, la tasa de mortalidad de causa infecciosa y muerte de origen desconocido es alta, lo cual plantea un desafío en el manejo de los pacientes postrasplante.

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“…It was not until 1972 that the first HTx was carried out in Peru by Molina's team at Hospital Nacional Edgardo Rebagliati Martins. However, it was an isolated case, and it was until 1993 when the first Peruvian HTx National Program was created with Pacheco's team with some continuity 7 . For a while since the late 1990s, HTxs were not carried out.…”

Section: Introductionmentioning

confidence: 99%

Heart transplantation at the Peruvian National Heart Institute: One‐decade single‐center experience

Pinto‐Salinas

Morón-Castro

Chavarri‐Velarde

et al. 2022

Journal of Cardiac Surgery

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Background Heart transplantations are ideal for most patients with end‐stage heart failure refractory to medical treatment. The transplantation program at the Peruvian National Heart Institute started with a 10‐year continuity in 2010. Objective To compare our 10‐year heart transplantation experience results with international standards and reflect on our Transplant Program. Methods We studied 83 patients who underwent orthotopic heart transplantation at a single center between January 2010 and December 2019. The recipients' profiles and survival rates were analyzed according to sex and age group, ensuring the information's confidentiality. Results The recipients' mean age was 41.2 ± 17 years, 88% were adults, and 68.7% were male. The main indications for transplantation were idiopathic dilated cardiomyopathy. 85.5% of recipients were clinically categorized as INTERMACS profiles 1–3 before transplantation. There was a significant difference between sexes regarding the preoperative left ventricular ejection fraction and between age groups regarding the waiting time. The average ischemia time was 3.1 h, operating time was 6.1 h, cardiopulmonary bypass time was 3 h, and aortic cross‐clamp time was 1.7 h. The principal early postoperative complications were hematological disorders and acute kidney failure. The principal late ones were kidney failure and severe anemia. The postoperative mortality was 15.9%, and the principal causes were infection and then acute rejection. The survival at 1, 5, and 10 years was 87.5%, 79.8%, and 79.8%, respectively. The survival results were not influenced by sex or age group. Conclusion Our patients' postoperative complications, mortality, and survival rates coincided with those reported by the ISHLT registry.

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Patología del trasplante cardiaco en el Perú: Experiencia con 61 casos en un centro de referencia nacional

Cited by 5 publications

References 16 publications

Heart transplantation at the Peruvian National Heart Institute: One-decade single-center experience

Heart transplantation at the Peruvian National Heart Institute: One-decade single-center experience

Características epidemiológicas de receptores de trasplante cardiaco en el Perú, 2010-2020

Heart transplantation at the Peruvian National Heart Institute: One‐decade single‐center experience

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