Use of Cardiac Allografts With Mild and Moderate Left Ventricular Hypertrophy Can Be Safely Used in Heart Transplantation to Expand the Donor Pool
| Autor: | Robert M. Kass, Michele A. De Robertis, Alfredo Trento, James Mirocha, Robert J. Siegel, Gregory P. Fontana, Lawrence S.C. Czer, Sharo Raissi, Wen Cheng, Jason Lee, Sorel Goland |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Tissue and Organ Procurement Adolescent Heart Ventricles medicine.medical_treatment Left ventricular hypertrophy Severity of Illness Index Muscle hypertrophy Internal medicine Severity of illness medicine Humans Transplantation Homologous cardiovascular diseases Interventricular septum Survival rate Heart transplantation business.industry Middle Aged medicine.disease Tissue Donors Surgery Survival Rate Transplantation Treatment Outcome medicine.anatomical_structure Echocardiography Circulatory system Cardiology Heart Transplantation Female Hypertrophy Left Ventricular business Cardiology and Cardiovascular Medicine |
| Zdroj: | Journal of the American College of Cardiology. 51(12):1214-1220 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2007.11.052 |
| Popis: | ObjectivesThe purpose of this study was to evaluate outcomes of heart transplantation (HTx) and changes in left ventricular wall thickness (LVWT) post-HTx using donors with left ventricular hypertrophy (LVH).BackgroundLimited data are available on use of donor hearts with LVH in HTx.MethodsWe reviewed 427 patients who underwent HTx: 62 received hearts with LVH (interventricular septum [IVS] or posterior wall [PW] thickness ≥1.2 cm) by echocardiography, and 365 received hearts without LVH. The median follow-up was 3.8 years (range 0 to 16.2 years).ResultsRecipient age was 56 ± 11 years and donor age was 30 ± 12 years. Baseline recipient characteristics were similar in both groups. Donors with LVH were older (35 ± 12 years vs. 29 ± 12 years, p = 0.001) and had higher rates of intracranial hemorrhage (38% vs. 15%, p = 0.001). The LVWT was increased in the LVH group compared with LVWT in the non-LVH group (IVS: 1.28 ± 0.18 cm vs. 0.85 ± 0.19 cm, PW: 1.27 ± 0.19 cm vs. 0.85 ± 0.20 cm, p = 0.0001 for both groups). Mild LVH (1.2 to 1.3 cm) was found in 42%, moderate (>1.3 to 1.7 cm) in 53%, and severe (>1.7 cm) in 5% of donors with LVH. Left ventricular wall thickness regression occurred in both IVS and PW (1.28 ± 0.18 cm vs. 1.10 ± 0.13 cm vs. 1.13 ± 0.14 cm, and 1.27 ± 0.19 cm vs. 1.11 ± 0.11 cm vs. 1.13 ± 0.14 cm, at baseline, 1 year, and 5 years, respectively; p < 0.001 for change from baseline to 1 and 5 years for both locations). Patients with or without donor LVH had similar 1-year (3.5% vs. 9.5%, p = 0.2) and 5-year survival rates (84 ± 5.9% vs. 70 ± 2.7%, p = 0.07).ConclusionsShort- and long-term survival rates and rates of LVH at follow-up were similar in both groups, suggesting that donor hearts with mild and moderate LVH can be safely used in HTx. |
| Databáze: | OpenAIRE |
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