Retransplantation in 7,290 primary transplant patients: a 10-year multi-institutional study

Radovančević, Branislav; McGiffin, David C.; Kobashigawa, Jon A.; Cintrón, Guillermo; Mullen, G. M.; Pitts, Douglas E.; O’Donnell, Jacqueline; Thomas, Cynthia D.; Bourge, Robert C.; Naftel, David C.

doi:10.1016/s1053-2498(02)00803-3

Cited by 107 publications

(98 citation statements)

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“…Given the limited number of available donor hearts, the long-term results of this treatment option need to be evaluated. In this systematic review and meta-analysis, the three major indications for heart RTx (coronary allograft vasculopathy, early graft failure and acute rejection) mirror those seen in other heart RTx experiences (20,23). We demonstrate that patients who underwent RTx had a significantly lower survival than those who only underwent primary HTx, principally due to a high early mortality amongst RTx patients.…”

Section: Discussionmentioning

confidence: 71%

“…An early study of RTx at 13 centers revealed a 1-year survival of only 60% (17). Another study reporting on the outcomes from the Cardiac Transplant Research Database of 106 RTx recipients also confirm that survival after RTx was inferior to primary HTx with a survival of 56% at 1 year and 38% at 5 years (20).…”

Section: Discussionmentioning

confidence: 85%

“…Although different surgical and medical options have been proposed to overcome allograft failure such as revascularization, valvular repair, mechanical assistance and new pharmacological regimens (8,(12)(13)(14)(15), heart RTx remains the only definitive management for these patients. Previous studies have demonstrated that outcomes following RTx are inferior to those for primary HTx (10,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Given the limited number of available donor hearts, the long-term results of this treatment option need to be evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…A previous analysis of the Joint ISHLT/United Network for Organ Sharing Thoracic Registry suggested that the outcome following RTx was significantly affected by the time between transplants, where an inter-transplant interval of less than 2 years resulted in a 2-year survival less than 60% (19). Furthermore, an analysis of data in the Cardiac Transplant Research Database showed that survival following RTx were lowest for acute rejection (32% and 8% at 1 and 5 years, respectively) and early graft failure (50% and 39% at 1 and 5 years, respectively) (20). In another report from Columbia University, the authors reported that since 1993, when selection criteria for RTx excluded those with primary allograft failure and intractable acute rejection occurring less than 6 months after HTx, 1-, 2-and 4-year survival following RTx was 94%, 94% and 94%, respectively (24).…”

Section: Discussionmentioning

confidence: 99%

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Outcomes and survival following heart retransplantation for cardiac allograft failure: a systematic review and meta-analysis

Rizvi

Luc

Choi

et al. 2018

Ann. Cardiothorac. Surg.

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Background: Long-term efficacy of heart retransplantation (RTx) for end-stage cardiac allograft failure remains unclear given the limited worldwide experience and is an important question to elucidate given the shortage of donor organs. The aim of this systematic review was to examine the outcomes of RTx in patients with cardiac allograft failure.Methods: Electronic search was performed to identify all studies in the English literature assessing RTx for cardiac allograft failure. All identified articles were systematically assessed for inclusion and exclusion criteria.Results: Eleven studies were included for analysis, with a total of 7,791 patients. A total of 7,446 patients underwent primary heart transplantation (HTx) whereas 345 patients underwent RTx with average time from primary HTx to RTx interval of 5.03 years (95% CI: 3.13-6.94 years). There were 35.2% of patients Conclusions:Patients who underwent heart RTx had a significant lower survival when compared to those who only underwent primary HTx. There were no significant differences in post-transplantation freedom from rejection. Careful patient selection and perioperative care can make heart RTx a viable option for selected recipients.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes and survival following heart retransplantation for cardiac allograft failure: a systematic review and meta-analysis

Rizvi

Luc

Choi

et al. 2018

Ann. Cardiothorac. Surg.

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“…2,5,14 Retransplantation remains the last therapeutic option for cardiac allograft failure due to progressive CAV. [31][32][33][34][35] Unfortunately, this therapeutic option is limited mostly because of organ shortage and associated with long waiting times. 36 Therefore, bridge to retransplantation and bridge to destination with a ventricular assist device might be lifesaving.…”

mentioning

confidence: 99%