Outcome of heart transplants 15 to 20 years ago: graft survival, post-transplant morbidity, and risk factors for mortality
| Autor: | Philippe Bizouarn, Jean Luc Michaud, Michèle Treilhaud, Jean Christian Roussel, D. Duveau, Philippe Despins, Jean Noël Trochu, Guillaume Lamirault, Antoine Mugniot, Oussama Al Habash, Olivier Baron, Sabine Pattier, Jean Pierre Gueffet, Thierry Petit, Marie-Françoise Heymann, Christian Perigaud |
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| Rok vydání: | 2007 |
| Předmět: |
Pulmonary and Respiratory Medicine
Graft Rejection Male medicine.medical_specialty Time Factors Heart Diseases medicine.medical_treatment Single Center Malignancy Coronary artery disease Risk Factors medicine Humans Risk factor Dialysis Retrospective Studies Heart transplantation Transplantation business.industry Graft Survival Retrospective cohort study Middle Aged medicine.disease Surgery Treatment Outcome Cyclosporine Heart Transplantation Female Morbidity Cardiology and Cardiovascular Medicine business Immunosuppressive Agents |
| Zdroj: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 27(5) |
| ISSN: | 1557-3117 |
| Popis: | Objectives The study was conducted to determine the long-term outcome of patients who underwent heart transplantation 15 to 20 years ago, in the cyclosporine era, and identify risk factors for death. Methods A retrospective analysis was done of 148 patients who had undergone heart transplantation between 1985 and 1991 at a single center. Operative technique and immunosuppressive treatment were comparable in all patients. Results Actuarial survival rates were 75% (n = 111), 58% (n = 86), and 42% (n = 62) at 5, 10, and 15 years, respectively. The mean follow-up period was 12.1 ± 5.6 years for patients who survived more than 3 months after transplantation (n = 131). The major causes of death were malignancy (35.8%) and cardiac allograft vasculopathy (24.7%). No death related to acute rejection was reported after the first month of transplantation. Graft coronary artery disease was detected on angiography in 66 (50.3%), and 7 (5.3%) had retransplantation. Malignancies developed in 131 patients (48.1%), including skin cancers in 31 (23.6%), solid tumors in 26 (19.8%), and hematologic malignancies in 14 (10.6%). Severe renal function requiring dialysis or renal transplantation developed in 27 patients (20.6%). By multivariable analysis, the only pre-transplant risk factor found to affect long-term survival was a history of cigarette use ( p Conclusions Long-term survival at 15 years after cardiac transplantation remains excellent in the cyclosporine era. Controlling acute allograft rejection can be achieved but seems to carry a high rate of cancers and renal dysfunction. History of cigarette use affects significantly long-term survival in our study. |
| Databáze: | OpenAIRE |
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