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Abstract

Objectives: The identification of variables related to the survival of heart transplant patients is vital for a good medical practice. Few studies have examined this issue in a Latin American population. Therefore, the aim of this study was to analyze, retrospectively, the survival and mortality characteristics of patients after heart transplant. Materials and Methods: Information on patients was obtained through review of medical records; we collected information on all patients who underwent this procedure from 2010 to 2015. Sociodemographic, clinical, and surgical characteristics associated with posttransplant mortality were analyzed. Survival over 5 years was determined with the Kaplan-Meier method. Results: The overall survival rate of the 35 patients who underwent heart transplant was 85%. Those with low total cholesterol values (< 160 mg/dL) had a lower survival at 5 years than patients with higher values (74% vs 100%; P = .044). The overall mortality was 14.3%, and the main cause of death was acute graft rejection (40%). Lower total cholesterol level (< 160 mg/dL; P = .036), presence of chronic kidney disease stage 1 (P = .049), intraoperative bleeding (> 600 mL; P = .013), and number of sepsis incidents (P = .03) were more frequent in patients who died. Conclusions: The survival in our institute at 5 years is higher than shown in the reported literature, and the mortality is lower. In addition, a low total cholesterol value negatively affects survival of heart transplant patients at 5 years. Key words: Cardiac surgery, Cholesterol, Graft rejection, Sepsis IntroductionCompared with past decades, the International Society for Heart and Lung Transplantation and other institutions have recorded improved survival after heart transplant at 1, 5, and 10 years. 1,2 This is relevant because this surgical procedure remains the treatment of choice in patients with severe heart failure from different causes. 3 Data have also demonstrated survival greater than 20 years after heart transplant. 4 However, survival continues to be below 80% at 5 years in various institutions. 2,5 Survival after heart transplant is affected by several mortality factors from both the recipient and the donor. 6 For the recipient, age, body mass index, high preoperative creatinine level, ischemic time, cardiovascular diseases or hematologic-associated causes, and the patient's psychological state can affect survival. 2,7-10 For the donor, higher age, donor diabetes mellitus history, and sex mismatch or race mismatch can increase the recipients' mortality after heart transplant. 9,11 The principal causes of death after this procedure include cardiac graft vasculopathy, primary graft failure, graft rejection, infection, and neoplasia. 12,13 In recent years, new developments to minimize the causes of death have been implemented, thus raising survival rates. 14 These include the implementation of more protocols, strict sanitary policies, and the combination and use of better immunosuppressive therapy. 6 Most studies have been done on p...

Value of blood lipid in predicting graft dysfunction after organ and tissue transplantation: A study of Mendelian randomization

“…For instance, Booth et al reported that pre-transplant total cholesterol levels >5.5 mmol/L are associated with higher patient survival but show no difference in graft survival [ 25 ]. Another retrospective clinical study demonstrated that lower total cholesterol levels (<160 mg/dL) negatively impact the survival of heart transplant patients at the 5-year mark [ 26 ]. Additionally, Soltanian et al observed that lower LDL cholesterol levels before transplantation can decrease the risk of graft loss after kidney transplantation [ 27 ].…”