Factors predicting 10-year survival after heart transplantation

被引:53
作者
Radovancevic, B [1 ]
Konuralp, C [1 ]
Vrtovec, B [1 ]
Radovancevic, R [1 ]
Thomas, CD [1 ]
Zaqqa, M [1 ]
Vaughn, WK [1 ]
Frazier, OH [1 ]
机构
[1] St Lukes Episcopal Hosp, Texas Heart Inst, Dept Cardiopulm Transplantat, Houston, TX 77225 USA
关键词
D O I
10.1016/j.healun.2003.11.399
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: We sought to identify factors predictive of long-term(> 10-year) survival in heart transplant (HTx) recipients. Methods: Four hundred fifteen adult patients underwent HTx at our institution between August 1982 and May 1997. The 158 patients who survived > 10 years (Group A) and the 116 patients who died between 2 and 6 years (Group B) of HTx were compared in terms of gender, gender mismatch, ethnicity, age, height, weight, United Network for Organ Sharing status, type of induction therapy (OKT3. or anti-thymocyte globulin), infections (bacterial, viral, fungal and protozoal), cytomegalovirus (CMV) status, CMV mismatch, diabetes mellitus, hypertension and incidence of rejection episodes nd transplant, coronary artery disease within 2 years of. HTx. Results: Group A (135 men, 23 women; mean age 48 +/- 11 years) had significantly fewer post-HTx rejection episodes and viral, bacterial, fungal and total infections than did Group B (95 men, 21 women; mean age 49 +/- 12 years). Group A also had a significantly lower mean donor age, a lower incidence of pre-HTx diabetes, and a lower mean cholesterol level 1 year after HTx. In a multivariate analysis, fewer bacterial infections and rejection episodes after HTx, the absence of pre-HTx diabetes, and lower donor age were associated with longer survival. Conclusions: Pre-HTx diabetes, donor age and incidences of infection and rejection within 2 years of HTx predict long-term (> 10-year) survival. Better control of infection and rejection during the first. 2 years after HTx may, improve survival.
引用
收藏
页码:156 / 159
页数:4
相关论文
共 14 条
[11]   DONOR SHORTAGE IN HEART-TRANSPLANTATION [J].
LIVI, U ;
BORTOLOTTI, U ;
LUCIANI, GB ;
BOFFA, GM ;
MILANO, A ;
THIENE, G ;
CASAROTTO, D .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1994, 107 (05) :1346-1355
[12]   Infectious complications among 620 consecutive heart transplant patients at Stanford University Medical Center [J].
Montoya, JG ;
Giraldo, LF ;
Efron, B ;
Stinson, EB ;
Gamberg, P ;
Hung, S ;
Giannetti, N ;
Miller, J ;
Remington, JS .
CLINICAL INFECTIOUS DISEASES, 2001, 33 (05) :629-640
[13]   The Registry of the International Society for Heart and Lung Transplantation: Twentieth official adult heart transplant report - 2003 [J].
Taylor, DO ;
Edwards, LB ;
Mohacsi, PJ ;
Boucek, MM ;
Trulock, EP ;
Keck, BM ;
Hertz, MI .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2003, 22 (06) :616-624
[14]  
WARNECKE H, 1992, J HEART LUNG TRANSPL, V11, P1093