Pretransplant risk factors of early mortality after orthotopic heart transplantation

Espinoza, C; Manito, Nicolás; Castells, E; Roca, Josep; Rodríguez, R. López; Toledo, M.C Octavio de; Calbet, J.M; Fontanillas, C.; Saura, E; Granados, J; Benito, Mónica; Mauri, Francesco; Ramón, José; Obi, Chizoba; Quilès, Clélia; Claret, G

doi:10.1016/s0041-1345(99)00438-8

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…[26][27][28][29] Posttransplant survival in patients with fixed PH is significantly worse compared with patients with normal PVR in both short and long-term follow-ups. [3][4][5][6][7]29 In the present study, LVADs decreased fixed PH during a 6-week period of support. PH in terminal heart failure, at least in part, is the consequence of elevated left atrial filling pressures resulting from impaired left ventricular systolic function.…”

Section: Discussionmentioning

confidence: 95%

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Left ventricular assist devices decrease fixed pulmonary hypertension in cardiac transplant candidates

Zimpfer

Zrunek

Roethy

et al. 2007

The Journal of Thoracic and Cardiovascular Surgery

170

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Section: Discussionmentioning

confidence: 95%

“…The reason for this is the unacceptably high risk of acute donor right-sided heart failure immediately after implantation. [3][4][5][6][7] There is consensus that the risk of death after cardiac transplantation is increased in patients with pulmonary From the Departments of Cardiothoracic Surgery, a Biomedical Engineering, b and Cardiovascular Anesthesiology,…”

mentioning

confidence: 99%

Left ventricular assist devices decrease fixed pulmonary hypertension in cardiac transplant candidates

Zimpfer

Zrunek

Roethy

et al. 2007

The Journal of Thoracic and Cardiovascular Surgery

170

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“…However, socioeconomic, demographic and psychosocial factors that influence access to healthcare resources as well as patient compliance following transplant may also be important determinants of patient outcome following transplant. Indeed, psychosocial evaluations that assess these factors appear to be useful in identifying adult OHT recipients at higher risk of adverse outcome (5–7). Psychosocial evaluation of the recipient is routinely performed at most centers prior to listing for OHT and is considered a requirement by third party payers.…”

mentioning

confidence: 99%

Association of parental pretransplant psychosocial assessment with post‐transplant morbidity in pediatric heart transplant recipients*

Stone

Banerjee

Dupuis

et al. 2006

Pediatric Transplantation

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Because parents assume the primary responsibility for providing ambulatory post-transplant care to pediatric patients, pretransplant psychosocial evaluation in these recipients is usually focused on parents rather than on patients themselves. We sought to determine whether pretransplant parental psychosocial evaluation predicts post-transplant medical outcome at current levels of psychosocial support. We compared relative risk (RR) of rejection and hospitalizations (days of all-cause hospitalization) following initial discharge in patients in 'risk' and 'control' groups defined by their pretransplant parental psychosocial evaluation. We also compared the two groups of patients for the proportion of all outpatient trough cyclosporine A (CSA) or tacrolimus (FK) levels that were < 50% of the target level (defined as the mid-therapeutic range level). There were seven patients in the 'risk' group with a median age 0.25 yr (range 0.19-14.7 yr) and total follow up 20.5 patient-yr. There were 21 patients in the 'control' groups with a median age of 2.1 yr (range 0.05-16.2 yr) and total follow up of 71.3 patient-yr. There was no significant difference between the groups in rejection-risk or days of all-cause hospitalization early after transplant (first six months). During the late period (after the first six months), there were 11 rejection episodes in the 'risk' group over 17.4 patient-yr and four rejection episodes in control group over 61.8 patient-yr of follow up. After adjustment for age and race, patients in the 'risk' category had a RR of 3.4 for developing a rejection episode (p = 0.06) and 3.1 for being inpatient (p < 0.001) during the late period. Patients in the risk group were 2.9 times more likely to have subtherapeutic trough levels (< 50% target level) of calcineurin inhibitor (CSA or FK) during both early and late periods (p < 0.01 for both periods) after adjustment for patient age and race. We conclude that pretransplant parental psychosocial risk assessment is associated with post-transplant morbidity in children after cardiac transplantation. These patients may benefit from closer outpatient monitoring and a higher level of psychosocial support.

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Recipient selection in cardiac transplantation: contraindications and risk factors for mortality

Cimato¹,

Jessup²

2002

The Journal of Heart and Lung Transplantation

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Pretransplant risk factors of early mortality after orthotopic heart transplantation

Cited by 3 publications

References 7 publications

Left ventricular assist devices decrease fixed pulmonary hypertension in cardiac transplant candidates

Left ventricular assist devices decrease fixed pulmonary hypertension in cardiac transplant candidates

Association of parental pretransplant psychosocial assessment with post‐transplant morbidity in pediatric heart transplant recipients*

Recipient selection in cardiac transplantation: contraindications and risk factors for mortality

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