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Sadeghpour Tabaei, Ali, Hashemi, Parham. (1403). Intra-operative Risk Factors Affecting Mortality after Heart Transplantation: A Referral Center Experience in Iran. سامانه مدیریت نشریات علمی, 49(6), 359-368. doi: 10.30476/ijms.2023.99165.3122
Ali Sadeghpour Tabaei; Parham Hashemi. "Intra-operative Risk Factors Affecting Mortality after Heart Transplantation: A Referral Center Experience in Iran". سامانه مدیریت نشریات علمی, 49, 6, 1403, 359-368. doi: 10.30476/ijms.2023.99165.3122
Sadeghpour Tabaei, Ali, Hashemi, Parham. (1403). 'Intra-operative Risk Factors Affecting Mortality after Heart Transplantation: A Referral Center Experience in Iran', سامانه مدیریت نشریات علمی, 49(6), pp. 359-368. doi: 10.30476/ijms.2023.99165.3122
Sadeghpour Tabaei, Ali, Hashemi, Parham. Intra-operative Risk Factors Affecting Mortality after Heart Transplantation: A Referral Center Experience in Iran. سامانه مدیریت نشریات علمی, 1403; 49(6): 359-368. doi: 10.30476/ijms.2023.99165.3122

Intra-operative Risk Factors Affecting Mortality after Heart Transplantation: A Referral Center Experience in Iran

Iranian Journal of Medical Sciences
مقاله 3، دوره 49، شماره 6، شهریور 2024، صفحه 359-368    اصل مقاله (282.9 K)
نوع مقاله: Original Article(s)
شناسه دیجیتال (DOI): 10.30476/ijms.2023.99165.3122
نویسندگان
Ali Sadeghpour Tabaei؛ Parham Hashemi*
Department of Cardiovascular Surgery, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
چکیده
Background: Heart transplantation is the preferred treatment for end-stage heart failure. This study investigated the intra-operative risk factors affecting post-transplantation mortality.
Methods: This single-center retrospective cohort study examined 239 heart transplant patients over eight years, from 2011-2019, at the oldest dedicated cardiovascular center, Shahid Rajaee Hospital (Tehran, Iran). The primary evaluated clinical outcomes were rejection, readmission, and mortality one month and one year after transplantation. For data analysis, univariate logistic regression analyses were conducted.
Results: In this study, 107 patients (43.2%) were adults, and 132 patients (56.8%) were children. Notably, reoperation due to bleeding was a significant predictor of one-month mortality in both children (OR=7.47, P=0.006) and adults (OR=172.12, P<0.001). Moreover, the need for defibrillation significantly increased the risk of one-month mortality in both groups (children: OR=38.00, P<0.001; adults: OR=172.12, P<0.001). Interestingly, readmission had a protective effect against one-month mortality in both children (OR=0.02, P<0.001) and adults (OR=0.004, P<0.001). Regarding one-year mortality, the use of extracorporeal membrane oxygenation (ECMO) was associated with a higher risk in both children (OR=7.64, P=0.001) and adults (OR=12.10, P<0.001). For children, reoperation due to postoperative hemorrhage also increased the risk (OR=5.14, P=0.020), while defibrillation was a significant risk factor in both children and adults (children: OR=22.00, P<0.001; adults: OR=172.12, P<0.001). The median post-surgery survival was 22 months for children and 24 months for adults.
Conclusion: There was no correlation between sex and poorer outcomes. Mortality at one month and one year after transplantation was associated with the following risk factors: the use of ECMO, reoperation for bleeding, defibrillation following cross-clamp removal, and Intensive Care Unit (ICU) stay. Readmission, on the other hand, had a weak protective effect.
کلیدواژه‌ها
Heart transplantation؛ Risk factors؛ Mortality؛ Survival
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مراجع
  1. Veen KM, Zijderhand CF, Caliskan K, Schoonen T, Mokhles MM, Bekkers JA, et al. Biatrial vs Bicaval orthotopic Heart Transplantation: A Systematic Review and Meta-Analysis. Determinants of outcome in patients with tricuspid valve. 2020:271.
  2. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129-200. doi: 10.1093/eurheartj/ehw128. PubMed PMID: 27206819.
  3. Jasseron C, Lebreton G, Cantrelle C, Legeai C, Leprince P, Flecher E, et al. Impact of Heart Transplantation on Survival in Patients on Venoarterial Extracorporeal Membrane Oxygenation at Listing in France. Transplantation. 2016;100:1979-87. doi: 10.1097/TP.0000000000001265. PubMed PMID: 27306536.
  4. Taylor DO, Stehlik J, Edwards LB, Aurora P, Christie JD, Dobbels F, et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult Heart Transplant Report-2009. J Heart Lung Transplant. 2009;28:1007-22. doi: 10.1016/j.healun.2009.08.014. PubMed PMID: 19782283.
  5. Bhatia DS, Bowen JC, Money SR, Van Meter CH, Jr., McFadden PM, Kot JB, et al. The incidence, morbidity, and mortality of surgical procedures after orthotopic heart transplantation. Ann Surg. 1997;225:686-93-4. doi: 10.1097/00000658-199706000-00006. PubMed PMID: 9230809; PubMed Central PMCID: PMCPMC1190870.
  6. Yusen RD, Edwards LB, Dipchand AI, Goldfarb SB, Kucheryavaya AY, Levvey BJ, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirty-third Adult Lung and Heart-Lung Transplant Report-2016; Focus Theme: Primary Diagnostic Indications for Transplant. J Heart Lung Transplant. 2016;35:1170-84. doi: 10.1016/j.healun.2016.09.001. PubMed PMID: 27772669.
  7. McCartney SL, Patel C, Del Rio JM. Long-term outcomes and management of the heart transplant recipient. Best Pract Res Clin Anaesthesiol. 2017;31:237-48. doi: 10.1016/j.bpa.2017.06.003. PubMed PMID: 29110796.
  8. Ahmadi ZH, Shafaghi S, Mandegar MH, Salehi M, Sharif Kashani B, Naghashzadeh F, et al. The Cost of Heart Transplant in Iran: A Multicenter Analysis. Int J Organ Transplant Med. 2021;12:23-9. PubMed PMID: 35509719; PubMed Central PMCID: PMCPMC9013497.
  9. Lund LH, Edwards LB, Dipchand AI, Goldfarb S, Kucheryavaya AY, Levvey BJ, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirty-third Adult Heart Transplantation Report-2016; Focus Theme: Primary Diagnostic Indications for Transplant. J Heart Lung Transplant. 2016;35:1158-69. doi: 10.1016/j.healun.2016.08.017. PubMed PMID: 27772668.
  10. Zahedi F, Fazel I. AN overview OF organ transplantation IN Iran over three decades: with special FOCUS ON renal trans-plantation. Iranian J Publ Health. 2009;38:138-49.
  11. Taylor DO, Edwards LB, Aurora P, Christie JD, Dobbels F, Kirk R, et al. Registry of the International Society for Heart and Lung Transplantation: twenty-fifth official adult heart transplant report--2008. J Heart Lung Transplant. 2008;27:943-56. doi: 10.1016/j.healun.2008.06.017. PubMed PMID: 18765186.
  12. Green A, McSweeney J, Ainley K, Bryant J. In my shoes: children’s quality of life after heart transplantation. Prog Transplant. 2007;17:199-207. doi: 10.1177/152692480701700307. PubMed PMID: 17944159; PubMed Central PMCID: PMCPMC2241742.
  13. Politi P, Piccinelli M, Fusar-Poli P, Klersy C, Campana C, Goggi C, et al. Ten years of “extended” life: quality of life among heart transplantation survivors. Transplantation. 2004;78:257-63. doi: 10.1097/01.tp.0000133537.87951.f2. PubMed PMID: 15280687.
  14. Crone CC, Wise TN. Psychiatric aspects of transplantation, III: Postoperative issues. Crit Care Nurse. 1999;19:28-38. PubMed PMID: 10614245.
  15. Teran-Escandon D, Teran-Ortiz L, Ormsby-Jenkins C, Evia-Viscarra ML, White DJ, Valdes-Gonzalez-Salas R. Psychosocial aspects of xenotransplantation: survey in adolescent recipients of porcine islet cells. Transplant Proc. 2005;37:521-4. doi: 10.1016/j.transproceed.2005.01.001. PubMed PMID: 15808697.
  16. Mehra MR, Crespo-Leiro MG, Dipchand A, Ensminger SM, Hiemann NE, Kobashigawa JA, et al. International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy-2010. J Heart Lung Transplant. 2010;29:717-27. doi: 10.1016/j.healun.2010.05.017. PubMed PMID: 20620917.
  17. Gonzalez-Vilchez F, Arizon JM, Segovia J, Almenar L, Crespo-Leiro MG, Palomo J, et al. Chronic renal dysfunction in maintenance heart transplant patients: the ICEBERG study. Transplant Proc. 2014;46:14-20. doi: 10.1016/j.transproceed.2013.09.031. PubMed PMID: 24507019.
  18. Kilic A, Conte JV, Shah AS, Yuh DD. Orthotopic heart transplantation in patients with metabolic risk factors. Ann Thorac Surg. 2012;93:718-24. doi: 10.1016/j.athoracsur.2011.11.054. PubMed PMID: 22305053.
  19. Luckraz H, Goddard M, Charman SC, Wallwork J, Parameshwar J, Large SR. Early mortality after cardiac transplantation: should we do better? J Heart Lung Transplant. 2005;24:401-5. doi: 10.1016/j.healun.2004.02.013. PubMed PMID: 15797739.
  20. Foroutan F, Alba AC, Guyatt G, Duero Posada J, Ng Fat Hing N, Arseneau E, et al. Predictors of 1-year mortality in heart transplant recipients: a systematic review and meta-analysis. Heart. 2018;104:151-60. doi: 10.1136/heartjnl-2017-311435. PubMed PMID: 28855271.
  21. Kirklin JK, Naftel DC, Bourge RC, McGiffin DC, Hill JA, Rodeheffer RJ, et al. Evolving trends in risk profiles and causes of death after heart transplantation: a ten-year multi-institutional study. J Thorac Cardiovasc Surg. 2003;125:881-90. doi: 10.1067/mtc.2003.168. PubMed PMID: 12698152.
  22. Doumouras BS, Alba AC, Foroutan F, Burchill LJ, Dipchand AI, Ross HJ. Outcomes in adult congenital heart disease patients undergoing heart transplantation: A systematic review and meta-analysis. J Heart Lung Transplant. 2016;35:1337-47. doi: 10.1016/j.healun.2016.06.003. PubMed PMID: 27431751.
  23. Lopez-Sainz A, Barge-Caballero E, Barge-Caballero G, Couto-Mallon D, Paniagua-Martin MJ, Seoane-Quiroga L, et al. Late graft failure in heart transplant recipients: incidence, risk factors and clinical outcomes. Eur J Heart Fail. 2018;20:385-94. doi: 10.1002/ejhf.886. PubMed PMID: 28580728.
  24. Breitenstein A, Steffel J. Devices in Heart Failure Patients-Who Benefits From ICD and CRT? Front Cardiovasc Med. 2019;6:111. doi: 10.3389/fcvm.2019.00111. PubMed PMID: 31457018; PubMed Central PMCID: PMCPMC6700378.
  25. Spartalis M, Nakajima K, Zweiker D, Spartalis E, Iliopoulos DC, Siasos G. Contemporary ICD Use in Patients with Heart Failure. Cardiol Ther. 2021;10:313-24. doi: 10.1007/s40119-021-00225-7. PubMed PMID: 34129228; PubMed Central PMCID: PMCPMC8555039.
  26. Paul MH, Theilen EO, Gregg DE, Marsh JB, Casten GG. Cardiac metabolism in experimental ventricular fibrillation. Circ Res. 1954;2:573-8. doi: 10.1161/01.res.2.6.573. PubMed PMID: 13209789.
  27. Gazmuri RJ, Berkowitz M, Cajigas H. Myocardial effects of ventricular fibrillation in the isolated rat heart. Crit Care Med. 1999;27:1542-50. doi: 10.1097/00003246-199908000-00023. PubMed PMID: 10470762.
  28. Xu W, Fu Y, Jiang L, Yang Z, Wang Y, Tang W, et al. Cardiopulmonary resuscitation ameliorates myocardial mitochondrial dysfunction in a cardiac arrest rat model. Am J Emerg Med. 2020;38:65-72. doi: 10.1016/j.ajem.2019.04.024. PubMed PMID: 31027936.
  29. Xie J, Weil MH, Sun S, Tang W, Sato Y, Jin X, et al. High-energy defibrillation increases the severity of postresuscitation myocardial dysfunction. Circulation. 1997;96:683-8. doi: 10.1161/01.cir.96.2.683. PubMed PMID: 9244243.
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