Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure.

Authors

Pavan Atluri MDFollow
William Hiesinger
Robert C Gorman
Alberto Pochettino
Mariell Jessup
Michael A Acker
Rohinton J Morris
Y Joseph Woo

Publication/Presentation Date

5-7-2008

Abstract

BACKGROUND: Although orthotopic heart transplantation has been an effective treatment for end-stage heart failure, the incidence of allograft failure has increased, necessitating treatment options. Cardiac retransplantation remains the only viable long-term solution for end-stage cardiac allograft failure. Given the limited number of available donor hearts, the long term results of this treatment option need to be evaluated.

METHODS: 709 heart transplants were performed over a 20 year period at our institution. Repeat cardiac transplantation was performed in 15 patients (2.1%). A retrospective analysis was performed to determine the efficacy of cardiac retransplantation. Variables investigated included: 1 yr and 5 yr survival, length of hospitalization, post-operative complications, allograft failure, recipient and donor demographics, renal function, allograft ischemic time, UNOS listing status, blood group, allograft rejection, and hemodynamic function.

RESULTS: Etiology of primary graft failure included transplant arteriopathy (n = 10), acute rejection (n = 3), hyperacute rejection (n = 1), and a post-transplant diagnosis of metastatic melanoma in the donor (n = 1). Mean age at retransplantation was 45.5 +/- 9.7 years. 1 and 5 year survival for retransplantation were 86.6% and 71.4% respectively, as compared to 90.9% and 79.1% for primary transplantation. Mean ejection fraction was 67.3 +/- 12.2% at a mean follow-up of 32.6 +/- 18.5 mos post-retransplant; follow-up biopsy demonstrated either ISHLT grade 1A or 0 rejection (77.5 +/- 95.7 mos post-transplant).

CONCLUSION: Cardiac retransplantation is an efficacious treatment strategy for cardiac allograft failure.

Volume

3

First Page

26

Last Page

26

ISSN

1749-8090

Published In/Presented At

Atluri, P., Hiesinger, W., Gorman, R. C., Pochettino, A., Jessup, M., Acker, M. A., Morris, R. J., & Woo, Y. J. (2008). Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure. Journal of cardiothoracic surgery, 3, 26. https://doi.org/10.1186/1749-8090-3-26

Disciplines

Medicine and Health Sciences

PubMedID

18462494

Department(s)

Department of Surgery

Document Type

Article