Long‐term effects of primary graft dysfunction after heart transplantation

Long‐term effects of primary graft dysfunction after heart transplantation

Background We studied the incidence of primary graft dysfunction (PGD), its impact on in‐hospital and follow‐up outcomes and searched for independent risk factors. Methods During an 18‐year period, 508 individuals underwent heart transplantation at our institution. Patients were diagnosed with none,...

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Veröffentlicht in:Journal of cardiac surgery 2022-05, Vol.37 (5), p.1290-1298
Hauptverfasser: Settepani, Fabrizio, Pedrazzini, Giovanna L., Olivieri, Guido M., Merlanti, Bruno, Cannata, Aldo, Lanfranconi, Marco, Frigerio, Maria, Russo, Claudio F.
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heart failure
long‐term
mechanical circulatory support
primary graft dysfunction
transplantation heart
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container_end_page 1298
container_issue 5
container_start_page 1290
container_title Journal of cardiac surgery
container_volume 37
creator Settepani, Fabrizio
Pedrazzini, Giovanna L.
Olivieri, Guido M.
Merlanti, Bruno
Cannata, Aldo
Lanfranconi, Marco
Frigerio, Maria
Russo, Claudio F.
description Background We studied the incidence of primary graft dysfunction (PGD), its impact on in‐hospital and follow‐up outcomes and searched for independent risk factors. Methods During an 18‐year period, 508 individuals underwent heart transplantation at our institution. Patients were diagnosed with none, mild, moderate or severe PGD according to ISHLT criteria. Results Thirty‐eight patients (7.5%) met the ISHLT criteria for mild PGD, 92 (18.1%) for moderate PGD and 23 (4.5%) for severe PGD. Patients were classified into none/mild PGD (77.4%) and moderate/severe PGD (22.6%) groups. In‐hospital mortality was 12.4% (7.8% for none/mild PGD and 28.7% for moderate/severe PGD; p 
doi_str_mv 10.1111/jocs.16364
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Methods During an 18‐year period, 508 individuals underwent heart transplantation at our institution. Patients were diagnosed with none, mild, moderate or severe PGD according to ISHLT criteria. Results Thirty‐eight patients (7.5%) met the ISHLT criteria for mild PGD, 92 (18.1%) for moderate PGD and 23 (4.5%) for severe PGD. Patients were classified into none/mild PGD (77.4%) and moderate/severe PGD (22.6%) groups. In‐hospital mortality was 12.4% (7.8% for none/mild PGD and 28.7% for moderate/severe PGD; p &lt; .001). Survival at 1, 5, and 15 years was 85.5 ± 1.9% versus 67.2 ± 4.5%, 80 ± 2.2% versus 63.5 ± 4.7%, and 60.4 ± 3.6% versus 45.9 ± 8.4%, respectively (p &lt; .001). Excluding the events occurring during the first month of follow‐up, survival was comparable between the two groups (93.1 ± 1.4% vs. 94.7 ± 2.6 at 1 year and 65.6 ± 3.8% vs. 70.4 ± 10.4% at 15 years, respectively; p = .88). Upon multivariate logistic regression analysis preoperative mechanical circulatory support (odds ratio [OR] = 5.86) and preoperative intra‐aortic balloon pump (IABP) (OR = 9.58) were independently associated with moderate/severe PGD. Conclusions Our results confirm that PGD is associated with poor in‐hospital outcome. The poor outcome does not extend beyond the first month of follow‐up, with comparable survival between patients with none/mild PGD and moderate/severe PGD in the short and long‐term. Mechanical circulatory support and preoperative IABP were found to be independent risk factors for moderate/severe PGD.</description><identifier>ISSN: 0886-0440</identifier><identifier>EISSN: 1540-8191</identifier><identifier>DOI: 10.1111/jocs.16364</identifier><identifier>PMID: 35229361</identifier><language>eng</language><publisher>United States</publisher><subject>heart failure ; long‐term ; mechanical circulatory support ; primary graft dysfunction ; transplantation heart</subject><ispartof>Journal of cardiac surgery, 2022-05, Vol.37 (5), p.1290-1298</ispartof><rights>2022 Wiley Periodicals LLC</rights><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3294-bd15dcb4bc7668585cbb0b691835022a93404a6466523774b174bbe78782ec273</citedby><cites>FETCH-LOGICAL-c3294-bd15dcb4bc7668585cbb0b691835022a93404a6466523774b174bbe78782ec273</cites><orcidid>0000-0001-5439-1420 ; 0000-0002-9421-2885 ; 0000-0002-8206-3536</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjocs.16364$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjocs.16364$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35229361$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Settepani, Fabrizio</creatorcontrib><creatorcontrib>Pedrazzini, Giovanna L.</creatorcontrib><creatorcontrib>Olivieri, Guido M.</creatorcontrib><creatorcontrib>Merlanti, Bruno</creatorcontrib><creatorcontrib>Cannata, Aldo</creatorcontrib><creatorcontrib>Lanfranconi, Marco</creatorcontrib><creatorcontrib>Frigerio, Maria</creatorcontrib><creatorcontrib>Russo, Claudio F.</creatorcontrib><title>Long‐term effects of primary graft dysfunction after heart transplantation</title><title>Journal of cardiac surgery</title><addtitle>J Card Surg</addtitle><description>Background We studied the incidence of primary graft dysfunction (PGD), its impact on in‐hospital and follow‐up outcomes and searched for independent risk factors. Methods During an 18‐year period, 508 individuals underwent heart transplantation at our institution. Patients were diagnosed with none, mild, moderate or severe PGD according to ISHLT criteria. Results Thirty‐eight patients (7.5%) met the ISHLT criteria for mild PGD, 92 (18.1%) for moderate PGD and 23 (4.5%) for severe PGD. Patients were classified into none/mild PGD (77.4%) and moderate/severe PGD (22.6%) groups. In‐hospital mortality was 12.4% (7.8% for none/mild PGD and 28.7% for moderate/severe PGD; p &lt; .001). Survival at 1, 5, and 15 years was 85.5 ± 1.9% versus 67.2 ± 4.5%, 80 ± 2.2% versus 63.5 ± 4.7%, and 60.4 ± 3.6% versus 45.9 ± 8.4%, respectively (p &lt; .001). Excluding the events occurring during the first month of follow‐up, survival was comparable between the two groups (93.1 ± 1.4% vs. 94.7 ± 2.6 at 1 year and 65.6 ± 3.8% vs. 70.4 ± 10.4% at 15 years, respectively; p = .88). Upon multivariate logistic regression analysis preoperative mechanical circulatory support (odds ratio [OR] = 5.86) and preoperative intra‐aortic balloon pump (IABP) (OR = 9.58) were independently associated with moderate/severe PGD. Conclusions Our results confirm that PGD is associated with poor in‐hospital outcome. The poor outcome does not extend beyond the first month of follow‐up, with comparable survival between patients with none/mild PGD and moderate/severe PGD in the short and long‐term. Mechanical circulatory support and preoperative IABP were found to be independent risk factors for moderate/severe PGD.</description><subject>heart failure</subject><subject>long‐term</subject><subject>mechanical circulatory support</subject><subject>primary graft dysfunction</subject><subject>transplantation heart</subject><issn>0886-0440</issn><issn>1540-8191</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kMtKxDAUhoMozji68QEkSxE65tY0Xcow3ijMQl2HJE3HDr2MSYrMzkfwGX0SWzu69MDhcDgfP__5ATjHaI77ut60xs8xp5wdgCmOGYoETvEhmCIheIQYQxNw4v0GIUIYRcdgQmNCUsrxFGRZ26y_Pj6DdTW0RWFN8LAt4NaVtXI7uHaqCDDf-aJrTCjbBva7dfDVKhdgcKrx20o1QQ23U3BUqMrbs_2cgZfb5fPiPspWdw-LmywylKQs0jmOc6OZNgnnIhax0RppnmJB496iSilDTHHGeUxokjCN-9Y2EYkg1pCEzsDlqLt17VtnfZB16Y2teiO27bwknDLBeMoH9GpEjWu9d7aQ-88kRnJITw7pyZ_0evhir9vp2uZ_6G9cPYBH4L2s7O4fKfm4WjyNot_RHnrd</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Settepani, Fabrizio</creator><creator>Pedrazzini, Giovanna L.</creator><creator>Olivieri, Guido M.</creator><creator>Merlanti, Bruno</creator><creator>Cannata, Aldo</creator><creator>Lanfranconi, Marco</creator><creator>Frigerio, Maria</creator><creator>Russo, Claudio F.</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5439-1420</orcidid><orcidid>https://orcid.org/0000-0002-9421-2885</orcidid><orcidid>https://orcid.org/0000-0002-8206-3536</orcidid></search><sort><creationdate>202205</creationdate><title>Long‐term effects of primary graft dysfunction after heart transplantation</title><author>Settepani, Fabrizio ; Pedrazzini, Giovanna L. ; Olivieri, Guido M. ; Merlanti, Bruno ; Cannata, Aldo ; Lanfranconi, Marco ; Frigerio, Maria ; Russo, Claudio F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3294-bd15dcb4bc7668585cbb0b691835022a93404a6466523774b174bbe78782ec273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>heart failure</topic><topic>long‐term</topic><topic>mechanical circulatory support</topic><topic>primary graft dysfunction</topic><topic>transplantation heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Settepani, Fabrizio</creatorcontrib><creatorcontrib>Pedrazzini, Giovanna L.</creatorcontrib><creatorcontrib>Olivieri, Guido M.</creatorcontrib><creatorcontrib>Merlanti, Bruno</creatorcontrib><creatorcontrib>Cannata, Aldo</creatorcontrib><creatorcontrib>Lanfranconi, Marco</creatorcontrib><creatorcontrib>Frigerio, Maria</creatorcontrib><creatorcontrib>Russo, Claudio F.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiac surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Settepani, Fabrizio</au><au>Pedrazzini, Giovanna L.</au><au>Olivieri, Guido M.</au><au>Merlanti, Bruno</au><au>Cannata, Aldo</au><au>Lanfranconi, Marco</au><au>Frigerio, Maria</au><au>Russo, Claudio F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long‐term effects of primary graft dysfunction after heart transplantation</atitle><jtitle>Journal of cardiac surgery</jtitle><addtitle>J Card Surg</addtitle><date>2022-05</date><risdate>2022</risdate><volume>37</volume><issue>5</issue><spage>1290</spage><epage>1298</epage><pages>1290-1298</pages><issn>0886-0440</issn><eissn>1540-8191</eissn><abstract>Background We studied the incidence of primary graft dysfunction (PGD), its impact on in‐hospital and follow‐up outcomes and searched for independent risk factors. Methods During an 18‐year period, 508 individuals underwent heart transplantation at our institution. Patients were diagnosed with none, mild, moderate or severe PGD according to ISHLT criteria. Results Thirty‐eight patients (7.5%) met the ISHLT criteria for mild PGD, 92 (18.1%) for moderate PGD and 23 (4.5%) for severe PGD. Patients were classified into none/mild PGD (77.4%) and moderate/severe PGD (22.6%) groups. In‐hospital mortality was 12.4% (7.8% for none/mild PGD and 28.7% for moderate/severe PGD; p &lt; .001). Survival at 1, 5, and 15 years was 85.5 ± 1.9% versus 67.2 ± 4.5%, 80 ± 2.2% versus 63.5 ± 4.7%, and 60.4 ± 3.6% versus 45.9 ± 8.4%, respectively (p &lt; .001). Excluding the events occurring during the first month of follow‐up, survival was comparable between the two groups (93.1 ± 1.4% vs. 94.7 ± 2.6 at 1 year and 65.6 ± 3.8% vs. 70.4 ± 10.4% at 15 years, respectively; p = .88). Upon multivariate logistic regression analysis preoperative mechanical circulatory support (odds ratio [OR] = 5.86) and preoperative intra‐aortic balloon pump (IABP) (OR = 9.58) were independently associated with moderate/severe PGD. Conclusions Our results confirm that PGD is associated with poor in‐hospital outcome. The poor outcome does not extend beyond the first month of follow‐up, with comparable survival between patients with none/mild PGD and moderate/severe PGD in the short and long‐term. Mechanical circulatory support and preoperative IABP were found to be independent risk factors for moderate/severe PGD.</abstract><cop>United States</cop><pmid>35229361</pmid><doi>10.1111/jocs.16364</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5439-1420</orcidid><orcidid>https://orcid.org/0000-0002-9421-2885</orcidid><orcidid>https://orcid.org/0000-0002-8206-3536</orcidid></addata></record>
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subjects heart failure
long‐term
mechanical circulatory support
primary graft dysfunction
transplantation heart
title Long‐term effects of primary graft dysfunction after heart transplantation
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