Long-Term Outcome of Heart Transplant Recipients with Acute Graft Dysfunction Requiring Temporary Mechanical Circulatory Support

M. Urban, S. Lundgren, A. Siddique, B. Lowes, J. Um

Research output: Contribution to journalArticle

Abstract

PURPOSE: Mechanical circulatory support for acute graft dysfunction in heart transplant recipients is associated with increased early mortality and morbidity. Long-term outcome in patients who are successfully discharged from hospital is less well known. METHODS: We performed a retrospective review of results in all adult patients (age > 18) who received first time heart transplant at our institution between 2007 and 2017. We compared graft survival and freedom from acute cellular and antibody mediated rejection of 90-day survivors who required mechanical support for graft failure with those who did not. RESULTS: We performed 243 first time adult heart transplantations over the study period with 6% 90-day mortality and 68±5% 5-year patient survival. (62±5% graft survival with 4 patients necessitating re-transplantation for severe CAV). Short-term outcome of patients supported with various types of MCS is depicted in Table 1. Five-year graft survival, freedom from ACR and freedom from AMR was 87±3%, 82±3% and 92±2% in patients without the need for post-transplant MCS and 53±15%, 49±17% and 75±13% in patients requiring MCS (Figure 1). CONCLUSION: Heart transplant recipients who require post-operative mechanical support and survive 90 days experience decreased long-term survival and less freedom from both acute cellular and antibody mediated rejection.

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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