Effect of older donor age on risk for mortality after heart transplantation

Gupta, Dipin; Piacentino, Valentino; Macha, Mahender; Singhal, Arun; Gaughan, John; McClurken, James B.; Goldman, Bruce; Fisher, Carol A.; Beltramo, D.; Monacchio, John; Eisen, Howard J.; Furukawa, Satoshi

doi:10.1016/j.athoracsur.2004.02.016

Cited by 59 publications

(45 citation statements)

References 11 publications

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“…has been related to acute rejection. 7,8 The onset and severity of acute biopsy-proven rejection (BPR), as indicated by the time from transplantation to the development of the first rejection episode (regardless of rejection severity) and the incidence of a rejection episode rated as Grade Ն3A, were secondary endpoints. Finally, the composite end-point of death, the incidence of rejection Grade Ն3A, or early rejection was used to examine the risk of unfavorable outcomes after HTx.…”

Section: Outcomes Measuresmentioning

confidence: 99%

“…Female-to-male mismatch, donor and recipient age, allograft ischemia time, cause of brain death, cytomegalovirus (CMV) status, HLA sensitization and HLA mismatch have all been implied as risk factors for acute rejection. [5][6][7][8] Behavioral factors such as noncompliance with therapy and depression have also been related to acute rejections and poor prognosis post-HTx. 9 -11 Persistent symptoms of psychologic distress are prevalent among HTx patients 11,12 and have a negative impact on compliance.…”

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confidence: 99%

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Unfavorable Outcome of Heart Transplantation in Recipients With Type D Personality

Denollet

Vrints

et al. 2007

The Journal of Heart and Lung Transplantation

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Unfavorable outcome of heart transplantation in recipients with type D personalityDenollet, Johan; Holmes, R.V.F.H.; Vrints, C.J.; Conraads, V. Published in:The Journal of Heart and Lung Transplantation Document version:Publisher's PDF, also known as Version of record General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.-Users may download and print one copy of any publication from the public portal for the purpose of private study or research -You may not further distribute the material or use it for any profit-making activity or commercial gain -You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright, please contact us providing details, and we will remove access to the work immediately and investigate your claim. Background: The role of personality in heart transplantation (HTx) remains largely unknown. We examined the distressed personality (Type D) as a predictor of outcomes in patients suffering from end-stage heart disease who underwent HTx. Methods:Using the DS14 scale, 51 patients (75% men; 54.1 Ϯ 9.7 years of age) were diagnosed as Type D or non-Type D in the pre-transplant period. End-points of this prospective follow-up study (mean 5.4 years) were mortality and allograft rejection (Grade Ն3A rejection, rejection-free days after HTx). Results:At baseline, 15 patients were diagnosed as Type D and 36 as non-Type D; they did not differ in recipient or donor characteristics. At follow-up, there were 8 deaths; the mortality rate of Type D recipients was 33% vs 8% for non-Type Ds ( p ϭ 0.036). Two deaths were due to early post-operative complications and were excluded from further analyses. Type D recipients had a 10-fold higher mortality rate after hospital discharge (5 of 15, or 33%) as compared with non-Type D recipients (1 of 34, or 3%) ( p ϭ 0.013, adjusting for age and gender). Among surviving recipients, the rate of Grade Ն3A rejection for both groups was 40% vs 27%, respectively (p ϭ 0.45). The first episode of rejection was diagnosed, on average, after 14 days in Type D recipients vs after 50 days in the other patients (p ϭ 0.032). The risk of unfavorable outcomes (death, Grade Ն3A rejection, or number rejection-free days Յ14) was greater in Type D recipients (12 of 15, or 80%) than in non-Type Ds (13 of 34, or 38%), adjusting for other risk factors (odds ratio: 6.75; 95% confidence interval: 1.47 to 30.97) ( p ϭ 0.014). Conclusions: Type D personality independently predicted mortality and early allograft rejection, and should be accounted for when planning interventions to achieve optimal outcomes after HTx. J Heart Lung Transplant 2007;26:152-8.

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Section: Outcomes Measuresmentioning

confidence: 99%

mentioning

confidence: 99%

Unfavorable Outcome of Heart Transplantation in Recipients With Type D Personality

Denollet

Vrints

et al. 2007

The Journal of Heart and Lung Transplantation

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“…20-22 Donor age >40 years represents an important risk factor for survival after heart transplantation and the use of a donor age cutoff point of 40 years may be a useful clinical criterion. 20, 22 In our study, older donor age as a continuous variable was associated with the incidence of significant TR (P=0.012) and donor age >40 years as a categorical variable also affected the incidence of significant TR (P=0.008). The aged myocardium is known to undergo structural and functional changes.…”

Section: Discussionmentioning

confidence: 71%

Fate of Atrioventricular Valve Function of the Transplanted Heart

Kim

et al. 2014

Circ J

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“…Several donor-derived risk factors, such as age, are well known to have an effect on recipient survival. 11 Brain death may result in disturbed electrolyte homeostasis, leading to an excessive sodium level. 12, 1 A review of the current literature revealed an uncertain effect of hypernatremia on outcome after heart transplant; most reports are of liver transplant and are of limited sample size.…”

Section: Discussionmentioning

confidence: 99%

Is Severe Electrolyte Imbalance a Contraindication for Heart Transplant?

Sadeghi¹,

Mehr²,

Sadeghi³

et al. 2012

Exp Clin Transplant

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Owing to the increasing numbers of patients with end-stage congestive heart failure awaiting heart transplant and the limited number of suitable donor organs, a decrease in stringency of donor criteria has become widely accepted over the last decade. Here, we present a case of a heart donor with severe electrolyte imbalance, specifically severe hypokalemia, and severe hypernatremia. Despite this, heart transplant was a success, and the recipient was discharged from the hospital in good general condition. We recommend further study of this issue with a larger sample size.

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Effect of older donor age on risk for mortality after heart transplantation

Cited by 59 publications

References 11 publications

Unfavorable Outcome of Heart Transplantation in Recipients With Type D Personality

Unfavorable Outcome of Heart Transplantation in Recipients With Type D Personality

Fate of Atrioventricular Valve Function of the Transplanted Heart

Is Severe Electrolyte Imbalance a Contraindication for Heart Transplant?

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