Effect of prior cardiac surgery on survival after heart transplantation

Lammermeier, David E.; Nakatani, Takeshi; Sweeney, Michael S.; Buren, Charles T. Van; Macris, Michael P.; Duncan, James M.; Frazier, O. H.

doi:10.1016/0003-4975(89)90063-5

Cited by 31 publications

(27 citation statements)

References 11 publications

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“…Other complications include cytomegalovirus transmission and adult respiratory distress syndrome. Previous data demonstrate the relationship between previous heart surgeries and postoperative hemorrhage (9). Since ischemic cardiomyopathy is the leading indication for heart transplantation, it is quite common to have recipients with previous sternotomy (46% in our population).…”

Section: Discussionmentioning

confidence: 66%

Protective Effects of Recombinant Human Antithrombin III in Pig-to-Primate Renal Xenotransplantation

Tsai¹,

Marelli²,

Bresson³

et al. 2002

American Journal of Transplantation

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Older age, prior transplantation, pulmonary hypertension, and mechanical support are commonly seen in current potential cardiac transplant recipients. Transplants in 436 consecutive adult patients from 1994 to 1999 were reviewed. There were 251 using standard donors in 243 patients (age range 18-69 years). To emphasize recipient risk, 185 patients who received a nonstandard donor were excluded from analysis. The indications for transplant were ischemic heart disease (n Ω 123, 47%), dilated cardiomyopathy (n Ω 82, 32%), and others (n Ω 56, 21%). One hundred and forty-nine (57%) recipients were listed as status I; 5 and 6% were supported with an intra-aortic balloon and an assist device, respectively. The 30-d survival and survival to discharge were 94.7 and 92.7%, respectively; 1-year survival was 89.1%. Causes of early death were graft failure (n Ω 6), infection (n Ω 4), stroke (n Ω 4), multiorgan failure (n Ω 3) and rejection (n Ω 2). Predictors were balloon pump use alone (OR Ω 11.4, p Ω0.002), pulmonary vascular resistance Ͼ 4 Wood units (OR Ω 5.7, p Ω0.007), pretransplant creatinine Ͼ 2.0 mg/dL (OR Ω 6.9, p Ω0.004) and female donor (OR Ω 8.3, p Ω 0.002). Recipient age and previous surgery did not affect short-term survival. Heart transplantation in the current era consistently offers excellent early and 1-year survival for well-selected recipients receiving standard donors. Early mortality tends to reflect graft failure while hospital mortality may be more indicative of recipient selection.

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Section: Discussionmentioning

confidence: 66%

Protective Effects of Recombinant Human Antithrombin III in Pig-to-Primate Renal Xenotransplantation

Tsai¹,

Marelli²,

Bresson³

et al. 2002

American Journal of Transplantation

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“…[7,8] However, the current literature on the impact of reoperative sternotomy on outcomes after OHT is mixed. In 1989, Lammermeier et al [13] reported on 182 OHT patients, 72 of whom had a prior sternotomy. Although they found reoperative sternotomy was associated with an increased risk of reoperation for bleeding, the patients had similar 1 and 3-year survival.…”

Section: Reoperative Sternotomymentioning

confidence: 99%

“…Although they found reoperative sternotomy was associated with an increased risk of reoperation for bleeding, the patients had similar 1 and 3-year survival. [13] Since that time, several studies have found patients requiring a reoperative sternotomy at the time of OHT to have decreased short and long-term survival [2,3,12]; however, other studies, many of limited sample size, have found no survival difference. [6,[9][10][11] In our study, reoperative sternotomy was significantly associated with decreased survival.…”

Section: Reoperative Sternotomymentioning

confidence: 99%

“…increased length of stay; [6,9,12] longer operations, [2,6,9,12] cold ischemic time, [6] and CPB time [9,10,12]; increased blood product utilization, [3,6,9,10] risk of reoperation for bleeding, [2,3,6,9,13], and incidence of postoperative infection. [2] In addition to these complications, our study found OHT after prior sternotomy to be associated with an increased risk of stroke.…”

Section: Reoperative Sternotomymentioning

confidence: 99%

“…Although reoperative sternotomy is a known risk factor for morbidity and mortality after coronary bypass surgery, its impact on OHT outcomes is unclear. [2,3,[6][7][8][9][10][11][12][13] Moreover, most previous studies represent single center experiences of limited sample size. Additionally, most current OHT risk scores do not incorporate reoperative sternotomy because these data are not adequately captured by existing registries.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

442 Reoperative Sternotomy Is Associated with Increased Mortality after Heart Transplantation

George

Beaty

Ewald

et al. 2012

The Journal of Heart and Lung Transplantation

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Heart transplantation—An update

Blum¹,

Aravot

1996

Clinical Cardiology

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Summary:Cardiologists caring for heart transplant recipients must be familiar with the pharmacology, drug interactions, and drug toxicity of those agents used extensively in clinical practice (cyclosporine, prednisone, azathioprine, pol yclonal and monoclonal anti-T-cell agents) and the newer treatments [methotrexate, FK-506, rapamycin, mycophenolate mofetil (RS6 1443), deoxyspergualin, anti-CD4 monoclonal antibodies, total lymphoid irradiation, and photophoresis]. Another important aspect of medical follow-up is the detection, differential diagnosis, and treatment of allograft dysfunction. Hemodynamic abnormalities that occur as a result of rejection or a direct drug effect must be differentiated from physiologic changes. Cardiac allograft vasculopathy is the primary impediment to the long-term survival of heart transplant recipients. Immunopathogenesis, prevention, early detection, and treatment of allograft vasculopathy should be the major focus of heart transplantation research.

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Effect of prior cardiac surgery on survival after heart transplantation

Cited by 31 publications

References 11 publications

Protective Effects of Recombinant Human Antithrombin III in Pig-to-Primate Renal Xenotransplantation

Protective Effects of Recombinant Human Antithrombin III in Pig-to-Primate Renal Xenotransplantation

442 Reoperative Sternotomy Is Associated with Increased Mortality after Heart Transplantation

Heart transplantation—An update

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