Survival Analysis in Adult Heart Transplantation: Experience from a Brazilian Single Center.

Autor:	Ferraz DLM; Department of Cardiovascular Surgery, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Cunha CBCD; Department of Cardiovascular Surgery, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil.; Cardiovascular Research, Harvard Medical School, Boston, Massachusetts, United States of America., Figueira FAMDS; Department of Cardiovascular Surgery, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Silva ITC; Department of Cardiovascular Surgery, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Monteiro VS; Cardiology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Carneiro RMD; Cardiology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Castro BG; Department of Cardiovascular Surgery, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Requião MB; Department of Cardiovascular Surgery, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Oliveira VF; Department of Cardiovascular Surgery, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Silva PJXD; Organ Transplantation, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Tchaick RM; Department of Cardiovascular Surgery, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Furtado AFP; Perfusion, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Silva MFOD Filha; Cardiology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Souza RCF; Department of Ecology and Evolutionary Biology, The University of Arizona, Tucson, Arizona, United States of America., Mello MJG; Postgraduate Program, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil., Gallindo RM; Postgraduate Program, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil.
Jazyk:	angličtina
Zdroj:	Brazilian journal of cardiovascular surgery [Braz J Cardiovasc Surg] 2024 Sep 06; Vol. 39 (5), pp. e20230394. Date of Electronic Publication: 2024 Sep 06.
DOI:	10.21470/1678-9741-2023-0394
Abstrakt:	Introduction: Heart transplantation is the gold standard for advanced heart failure treatment. This study examines the survival rates and risk factors for early mortality in adult heart transplant recipients at a Brazilian center. Methods: This retrospective cohort study involved 255 adult heart transplant patients from a single center in Brazil. Data were collected from medical records and databases including three defined periods (2012-2015, 2016-2019, and 2020-2022). Statistical analysis employed Kaplan-Meier survival curves, Cox proportional hazards analysis for 30-day mortality risk factors, and Log-rank tests. Results: The recipients were mostly male (74.9%), and the mean age was 46.6 years. Main causes of heart failure were idiopathic dilated cardiomyopathy (33.9%), Chagas cardiomyopathy (18%), and ischemic cardiomyopathy (14.3%). The study revealed an overall survival of 68.1% at one year, 58% at five years, and 40.8% at 10 years after heart transplantation. Survivalimproved significantly over time, combining the most recent periods (2016 to 2022) it was 73.2% in the first year and 63% in five years. The main risk factors for 30-day mortality were longer time on cardiopulmonary bypass, the initial period of transplants (2012 to 2015), older age of the donor, and nutritional status of the donor (overweight or obese). The main causes of death within 30 days post-transplant were infection and primary graft dysfunction. Conclusion: The survival analysis by period demonstrated that the increased surgical volume, coupled with the team's experience and modifications to the immunosuppression protocol, contributed to the improved early and mid-term outcomes.
Databáze:	MEDLINE
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