Protective Effects of Recombinant Human Antithrombin III in Pig-to-Primate Renal Xenotransplantation
Autor: | Jessica Bresson, David W. Gjertson, Julie Tran, Reza Kermani, Antoine Hage, Hillel Laks, Gregg C. Fonarow, Michele A. Hamilton, Abbas Ardehali, Mark Plunkett, Jon A. Kobashigawa, Fardad Esmailian, Daniel Marelli, Jaime Moriguchi, Feng-Chun Tsai |
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Rok vydání: | 2002 |
Předmět: |
Heart transplantation
Transplantation Creatinine medicine.medical_specialty business.industry medicine.medical_treatment Dilated cardiomyopathy Disease medicine.disease Pulmonary hypertension Surgery chemistry.chemical_compound medicine.anatomical_structure chemistry Vascular resistance Immunology and Allergy Medicine Pharmacology (medical) business Stroke |
Zdroj: | American Journal of Transplantation. 2:539-545 |
ISSN: | 1600-6135 |
DOI: | 10.1034/j.1600-6143.2002.20608.x |
Popis: | 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 = 123, 47%), dilated cardiomyopathy (n = 82, 32%), and others (n = 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 = 6), infection (n = 4), stroke (n = 4), multiorgan failure (n = 3) and rejection (n = 2). Predictors were balloon pump use alone (OR = 11.4, p = 0.002), pulmonary vascular resistance > 4 Wood units (OR = 5.7, p = 0.007), pretransplant creatinine > 2.0 mg/dL (OR = 6.9, p = 0.004) and female donor (OR = 8.3, p = 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. |
Databáze: | OpenAIRE |
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