Risk Factor Analysis in Pediatric Heart Transplantation
| Autor: | Reiner Körfer, Lech Hornik, Andreas Bairaktaris, Gero Tenderich, Hans Stenlund, Yanto Sandy Tjang |
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| Rok vydání: | 2008 |
| Předmět: |
Cardiomyopathy
Dilated Graft Rejection Heart Defects Congenital Male Pulmonary and Respiratory Medicine Risk analysis medicine.medical_specialty Time Factors Adolescent Coronary Disease Risk Assessment Postoperative Complications Sex Factors Risk Factors medicine Humans Risk factor Child Intensive care medicine Transplantation Cardiopulmonary Bypass business.industry Body Weight Age Factors Infant Survival Analysis Tissue Donors Analisis factorial El Niño Child Preschool Heart Transplantation Female Surgery Pediatric heart transplantation Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Journal of Heart and Lung Transplantation. 27:408-415 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2008.01.007 |
| Popis: | Steady assessment of risk factors will enable identification of patients at higher risk for post-transplant death, and may thus improve organ utilization and outcomes. In this study we aimed to identify the risk factors of mortality in pediatric heart transplantation.Between November 1989 and February 2004, there were 116 orthotopic heart transplantations performed in patients18 years of age at our institution.The 30-day mortality risk was 12% (dilated cardiomyopathy 7%, congenital heart disease 26%; univariate analysis: p = 0.023). The main cause of 30-day mortality was primary graft failure (36%). The late mortality rate was 31 per 1,000 person-years. The main causes of late mortality were acute rejection (44%) and cardiac allograft vasculopathy (26%). The 1-, 5-, 10- and 15-year survival rates were 85%, 77%, 65% and 53%, respectively. Male donor (odds ratio [OR] 6.33, 95% confidence interval [CI] 1.11 to 36.01) and cardiopulmonary bypass210 minutes (OR 43.05, 95% CI 1.11 to 1,669) were risk factors for 30-day mortality. Risk factors for 1- and 5-year mortality were body weight ratio0.8 (OR 40.36, 95% CI 3.04 to 536.47) and male donor (OR 3.36, 95% CI 1.05 to 10.75), respectively. Recipient age1 year (OR 64.65, 95% CI 1.69 to 2,466.77) and donor-recipient body surface area mismatch of0.9 (OR 10.58, 95% CI 1.03 to 108.25) were risk factors for 10-year mortality.Pediatric heart transplantation can be performed with an expectation of excellent results. Certain risk factors suggest poorer outcomes. |
| Databáze: | OpenAIRE |
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