https://scholars.lib.ntu.edu.tw/handle/123456789/560315
標題: | Risk factors and prognosis of patients with primary graft failure after heart transplantation: An asian center experience | 作者: | JENG-WEI CHEN YIH-SHARNG CHEN NAI-HSIN CHI SHU-CHIEN HUANG HSI-YU YU NAI-KUAN CHOU CHIH-HSIEN WANG |
公開日期: | 2014 | 出版社: | Elsevier USA | 卷: | 46 | 期: | 3 | 起(迄)頁: | 914-919 | 來源出版物: | Transplantation Proceedings | 摘要: | Background Although primary graft failure (PGF) after heart transplantation is a feared complication, most reports have come from Western countries. We analyzed the incidence in our hospital and tried to determine the predictive risk factors for PGF that require mechanical circulatory support or high dosage of inotropic agents after heart transplantation. We observed the long-term prognosis of patients successfully surviving PGF. Methods For this retrospective review, 447 patients undergoing heart transplantation between January 1990 and January 2013 were enrolled in our study. We compared the clinical data between patients with PGF and without PGF. The risk factors associated with PGF were analyzed, and the long-term survival curve was analyzed using a Kaplan-Meier analysis. Results The incidence of PGF in our study was 36.2% (162 patients) and the overall PGF-related mortality rate was 17% (30 day in-hospital mortality). Independent risk factors for PGF included preoperative recipient hypoalbuminemia, high central venous pressure, United Network for Organ Sharing (UNOS) status 1A, dependence on inotropic agents, ventilator, intra-aortic balloon pump (IABP), and extracorporeal membrane oxygenation (ECMO), and longer ischemic time. Patients with PGF had poorer long-term survival than patients without PGF; the 1-year survival rate was 40% versus 76% (P <.01). The rate of weaning from ECMO for PGF was 46% (12 of 26 patients) and they have similar 1-year survival rates as non-EGF patients. Conclusions Several recipient and donor variables significantly influenced the PGF after heart transplantation. The mortality rate was higher in patients with PGF. However, patients who survived PGF have similar mid-term and long-term survival as patients without PGF. ? 2014 by Elsevier Inc. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84899578123&doi=10.1016%2fj.transproceed.2013.11.107&partnerID=40&md5=780d73b8e1f60c682b5fbaa7840a4f5c https://scholars.lib.ntu.edu.tw/handle/123456789/560315 |
ISSN: | 0041-1345 | DOI: | 10.1016/j.transproceed.2013.11.107 | SDG/關鍵字: | adult; Asia; conference paper; controlled study; extracorporeal oxygenation; female; graft failure; graft recipient; heart transplantation; human; incidence; Kaplan Meier method; long term survival; major clinical study; male; mortality; postoperative complication; preoperative period; primary graft failure; priority journal; prognosis; risk factor; survival rate; adolescent; aged; artificial ventilation; child; graft rejection; heart transplantation; infant; intraaortic balloon pump; middle aged; preschool child; Taiwan; young adult; cardiotonic agent; Adolescent; Adult; Aged; Cardiotonic Agents; Child; Child, Preschool; Extracorporeal Membrane Oxygenation; Female; Graft Rejection; Heart Transplantation; Humans; Incidence; Infant; Intra-Aortic Balloon Pumping; Male; Middle Aged; Prognosis; Respiration, Artificial; Risk Factors; Survival Rate; Taiwan; Young Adult |
顯示於: | 醫學系 |
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