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Impact of Circulatory Assistance in the Early Evolution After Heart Transplantation. Unicentric Experience

Martínez-Lauwers, Ana ; Arenas, Patricia ; Pérez-Roselló, Víctor ; Donoso, Víctor ; Ezzitouny, Maryem ; Lozano, Silvia ; Jover, Pablo ; Navarrete, Javier ; Sorolla, José A. ; López-Vilella, Raquel ; Sánchez-Lázaro, Ignacio ; Arnau, Miguel A. ; Almenar, Luis ; Martínez-Dolz, Luis

Transplantation proceedings, 2021-11, Vol.53 (9), p.2731-2733 [Revista revisada por pares]

Elsevier Inc

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  • Título:
    Impact of Circulatory Assistance in the Early Evolution After Heart Transplantation. Unicentric Experience
  • Autor: Martínez-Lauwers, Ana ; Arenas, Patricia ; Pérez-Roselló, Víctor ; Donoso, Víctor ; Ezzitouny, Maryem ; Lozano, Silvia ; Jover, Pablo ; Navarrete, Javier ; Sorolla, José A. ; López-Vilella, Raquel ; Sánchez-Lázaro, Ignacio ; Arnau, Miguel A. ; Almenar, Luis ; Martínez-Dolz, Luis
  • Es parte de: Transplantation proceedings, 2021-11, Vol.53 (9), p.2731-2733
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descripción: •Despite the fact that temporary circulatory support enables survival and adequate stabilization of the recipient before transplantation in a large number of cases, in our series its use as bridging therapy is associated with an increased risk of primary graft failure, frequent infection, and mortality 1 year after the procedure.•Mechanical ventilation added to circulatory support has a significant unfavorable prognostic impact.•Strategies that minimize the need for assisted ventilation should be implemented in these patients. Heart transplantation (HT) is the reference treatment for patients with terminal heart failure. In recent years there has been a progressive increase in HT procedures in patients who have a circulatory support (CS). This is a retrospective single-center study of 293 consecutive patients who underwent HT from 2009 to 2018, analyzing the evolution of the 2 cohorts: patients with and without CS as a bridge to HT. Baseline and evolutionary clinical data collected following the usual follow-up protocol were recorded, including clinical events observed during the follow-up 1 year after the procedure. The subgroup of patients transplanted with CS showed a higher incidence of primary graft failure, frequent infection, and mortality. A tendency toward lower cardiac allograft vasculopathy was observed in this subgroup. Mechanical ventilation added to the CS resulted in a higher incidence of primary graft failure, infection, and renal dysfunction. The CS variable as a bridge to HT was shown to be predictive of 1-year mortality in both univariate (odds ratio, 1.84; 95% confidence interval, 1.03-3.3; P = .038) and multivariate (odds ratio, 2.1; 95% confidence interval, 1.01-4.3; P = .047) analyses. In our experience, CS as a bridge to HT results in a higher incidence of primary graft failure, frequent infection, and mortality at 1-year follow-up. Mechanical ventilation added to CS has a clear unfavorable prognostic impact. CS as a bridge to HT was shown to be predictive of 1-year mortality in both univariate and multivariate analyses.
  • Editor: Elsevier Inc
  • Idioma: Inglés
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