Heart transplantation prognosis: Difference between revisions

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==Causes of Death after Transplantation==
==Causes of Death after Transplantation==
The following table outlines the common causes of death in post cardiac transplant patients <ref name="pmid19782283">{{cite journal| author=Taylor DO, Stehlik J, Edwards LB, Aurora P, Christie JD, Dobbels F et al.| title=Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult Heart Transplant Report-2009. | journal=J Heart Lung Transplant | year= 2009 | volume= 28 | issue= 10 | pages= 1007-22 | pmid=19782283 | doi=10.1016/j.healun.2009.08.014 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19782283  }} </ref>:
The following table outlines the common causes of death in post-cardiac transplant patients  


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Revision as of 19:17, 4 June 2020

Heart transplantation Microchapters

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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D.; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [1]

Prognosis

Factors determining prognosis

  • Donor factors-
    • Advanced donor age
    • prolonged ischemia time
  • Recipient factors-
    • The greatest one-year mortality was seen with the use of total artificial heart as a bridge to transplant or a need for end-organ support with mechanical ventilation or dialysis.
    • Best prognosis is seen if the indication for transplant is ischemic and nonischemic cardiomyopathy, whereas patients with a history of congenital heart disease, restrictive cardiomyopathy, and those undergoing retransplantation have worse prognosis.
    • Younger recipients (below age 55) have an advantage
    • Pre-transplant serum creatinine and total bilirubin are linearly related to survival.

Some other risk factors related to the recipient 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. [1]

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, [2]

Causes of Death after Transplantation

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

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. 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.
  2. Heart Transplant Patient OK After 28 Yrs (September 14, 2006) CBS News. Retrieved December 29, 2006.


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