Complications and prognosis: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 2: Line 2:
{{Heart transplant}}
{{Heart transplant}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{IF}}


==Overview==
==Overview==
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
The prognosis of the patient depends on a number of donor and recipient factors. If left untreated, patients develop acute graft rejection.


OR
Common complications of cardiac transplant include acute graft rejection, graft failure, infections, Cardiac allograft vasculopathy (CAV), malignancies, and late graft rejection.


Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
==Prognosis==
Factors determining [[prognosis]]
=== Donor factors===
Both the following factors are associated with an increased one-year mortality rate in the recipient.
*Advanced donor age <ref name="PotapovLoebe1999">{{cite journal|last1=Potapov|first1=Evgenij V.|last2=Loebe|first2=Matthias|last3=H??bler|first3=Michael|last4=Musci|first4=Michele|last5=Hummel|first5=Manfred|last6=Weng|first6=Yu-guo|last7=Hetzer|first7=Roland|title=MEDIUM-TERM RESULTS OF HEART TRANSPLANTATION USING DONORS OVER 63 YEARS OF AGE1|journal=Transplantation|volume=68|issue=12|year=1999|pages=1834–1838|issn=0041-1337|doi=10.1097/00007890-199912270-00002}}</ref>
*Prolonged [[ischemia]] time


OR
===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]] <ref name="KhushCherikh2018">{{cite journal|last1=Khush|first1=Kiran K.|last2=Cherikh|first2=Wida S.|last3=Chambers|first3=Daniel C.|last4=Goldfarb|first4=Samuel|last5=Hayes|first5=Don|last6=Kucheryavaya|first6=Anna Y.|last7=Levvey|first7=Bronwyn J.|last8=Meiser|first8=Bruno|last9=Rossano|first9=Joseph W.|last10=Stehlik|first10=Josef|title=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|journal=The Journal of Heart and Lung Transplantation|volume=37|issue=10|year=2018|pages=1155–1168|issn=10532498|doi=10.1016/j.healun.2018.07.022}}</ref>


Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
* Patients with a history of [[congenital heart disease]], [[restrictive cardiomyopathy]], and those undergoing retransplantation have a worse prognosis.
==Complications, and Prognosis==
* Younger recipients (below age 55) have an advantage
===Complications===
* Pre-transplant serum [[creatinine]] and total [[bilirubin]] are linearly related to survival.
*Common complications of [disease name] include:
**[Complication 1]
**[Complication 2]
**[Complication 3]


===Prognosis===
Some other risk factors are:
*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
* Use of [[Amiodarone]] pretransplantation
*Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
* Prior cardiac surgery
*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
* Transplantation of a female heart into a male or female recipient
*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
 
*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
Post-transplant survival has improved over time.
The median survival after adult heart transplants performed between 2002 and 2009 is 12.5 years, which extends to 14.8 years among 1-year survivors. <ref name="pmid31548031">{{cite journal| author=Khush KK, Cherikh WS, Chambers DC, Harhay MO, Hayes D, Hsich E | display-authors=etal| title=The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult heart transplantation report - 2019; focus theme: Donor and recipient size match. | journal=J Heart Lung Transplant | year= 2019 | volume= 38 | issue= 10 | pages= 1056-1066 | pmid=31548031 | doi=10.1016/j.healun.2019.08.004 | pmc=6816343 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31548031  }} </ref>
 
Tony Huesman was the world's longest-living heart transplant patient, having survived for 28 years with a transplanted heart. Huesman received a heart transplant in 1978 at Stanford University under American heart transplant pioneer [[Norman Shumway|Dr. Norman Shumway]], <ref>[http://www.cbsnews.com/stories/2006/09/14/ap/health/mainD8K49NG86.shtml Heart Transplant Patient OK After 28 Yrs] (September 14, 2006) ''CBS News''. Retrieved December 29, 2006.</ref>
 
===Comlications and Causes of Death after Transplantation===
The following table outlines the common causes of death in post-cardiac transplant patients <ref name="MontoyaGiraldo2001">{{cite journal|last1=Montoya|first1=Jose G.|last2=Giraldo|first2=Luis F.|last3=Efron|first3=Bradley|last4=Stinson|first4=Edward B.|last5=Gamberg|first5=Pat|last6=Hunt|first6=Sharon|last7=Giannetti|first7=Nadia|last8=Miller|first8=Joan|last9=Remington|first9=Jack S.|title=Infectious Complications among 620 Consecutive Heart Transplant Patients at Stanford University Medical Center|journal=Clinical Infectious Diseases|volume=33|issue=5|year=2001|pages=629–640|issn=1058-4838|doi=10.1086/322733}}</ref>
 
 
{|class="wikitable" border="1"
|- align="center"
|'''First 30 days post-transplant'''
|'''From 1 month to 12 months post-transplant'''
|'''After 5 years post-transplant'''
|- align="left"
|
* [[Transplant rejection|Graft failure]] (42%)
* Multiorgan failure (12%)
* Non-[[CMV]] infections (13%)
|
* Non-[[CMV]] infections (33%)
* [[Transplant rejection|Graft failure]] (primary and non-specific) (18%)
* [[Transplant rejection#Acute rejection|Acute rejection]] (12%)
|
* Cardiac allograft vasculopathy (CAV)
* Late [[Transplant rejection|graft failure]] (Both together accounting for 33% of deaths)
* Malignancies (23%)
* Non-[[CMV]] infections (11%)
|}


==References==
==References==
{{Reflist|2}}
{{reflist|2}}
 
[[Category:Cardiology]]
[[Category:Surgical procedures]]
[[Category:Surgery]]


{{WH}}
{{WikiDoc Help Menu}}
{{WS}}
{{WikiDoc Sources}}
[[Category: (name of the system)]]

Revision as of 17:27, 22 June 2020

Template:Heart transplant

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ifrah Fatima, M.B.B.S[2]

Overview

The prognosis of the patient depends on a number of donor and recipient factors. If left untreated, patients develop acute graft rejection.

Common complications of cardiac transplant include acute graft rejection, graft failure, infections, Cardiac allograft vasculopathy (CAV), malignancies, and late graft rejection.

Prognosis

Factors determining prognosis

Donor factors

Both the following factors are associated with an increased one-year mortality rate in the recipient.

Recipient factors

Some other risk factors are:

  • Use of Amiodarone pretransplantation
  • Prior cardiac surgery
  • Transplantation of a female heart into a male or female recipient

Post-transplant survival has improved over time. The median survival after adult heart transplants performed between 2002 and 2009 is 12.5 years, which extends to 14.8 years among 1-year survivors. [3]

Tony Huesman was the world's longest-living heart transplant patient, having survived for 28 years with a transplanted heart. Huesman received a heart transplant in 1978 at Stanford University under American heart transplant pioneer Dr. Norman Shumway, [4]

Comlications and Causes of Death after Transplantation

The following table outlines the common causes of death in post-cardiac transplant patients [5]


First 30 days post-transplant From 1 month to 12 months post-transplant After 5 years post-transplant
  • Cardiac allograft vasculopathy (CAV)
  • Late graft failure (Both together accounting for 33% of deaths)
  • Malignancies (23%)
  • Non-CMV infections (11%)

References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ Khush KK, Cherikh WS, Chambers DC, Harhay MO, Hayes D, Hsich E; et al. (2019). "The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult heart transplantation report - 2019; focus theme: Donor and recipient size match". J Heart Lung Transplant. 38 (10): 1056–1066. doi:10.1016/j.healun.2019.08.004. PMC 6816343 Check |pmc= value (help). PMID 31548031.
  4. ↑ Heart Transplant Patient OK After 28 Yrs (September 14, 2006) CBS News. Retrieved December 29, 2006.
  5. ↑ Montoya, Jose G.; Giraldo, Luis F.; Efron, Bradley; Stinson, Edward B.; Gamberg, Pat; Hunt, Sharon; Giannetti, Nadia; Miller, Joan; Remington, Jack S. (2001). "Infectious Complications among 620 Consecutive Heart Transplant Patients at Stanford University Medical Center". Clinical Infectious Diseases. 33 (5): 629–640. doi:10.1086/322733. ISSN 1058-4838.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Complications_and_prognosis&oldid=1616092"