Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 1;49(6):359-368.
doi: 10.30476/ijms.2023.99165.3122. eCollection 2024 Jun.

Intra-operative Risk Factors Affecting Mortality after Heart Transplantation: A Referral Center Experience in Iran

Ali Sadeghpour Tabaei  1 , Parham Hashemi  1
Affiliations

Intra-operative Risk Factors Affecting Mortality after Heart Transplantation: A Referral Center Experience in Iran

Ali Sadeghpour Tabaei et al. Iran J Med Sci. .

Abstract

Background: Heart transplantation is the preferred treatment for end-stage heart failure. This study investigated the intra-operative risk factors affecting post-transplantation mortality.

Methods: This single-center retrospective cohort study examined 239 heart transplant patients over eight years, from 2011-2019, at the oldest dedicated cardiovascular center, Shahid Rajaee Hospital (Tehran, Iran). The primary evaluated clinical outcomes were rejection, readmission, and mortality one month and one year after transplantation. For data analysis, univariate logistic regression analyses were conducted.

Results: In this study, 107 patients (43.2%) were adults, and 132 patients (56.8%) were children. Notably, reoperation due to bleeding was a significant predictor of one-month mortality in both children (OR=7.47, P=0.006) and adults (OR=172.12, P<0.001). Moreover, the need for defibrillation significantly increased the risk of one-month mortality in both groups (children: OR=38.00, P<0.001; adults: OR=172.12, P<0.001). Interestingly, readmission had a protective effect against one-month mortality in both children (OR=0.02, P<0.001) and adults (OR=0.004, P<0.001). Regarding one-year mortality, the use of extracorporeal membrane oxygenation (ECMO) was associated with a higher risk in both children (OR=7.64, P=0.001) and adults (OR=12.10, P<0.001). For children, reoperation due to postoperative hemorrhage also increased the risk (OR=5.14, P=0.020), while defibrillation was a significant risk factor in both children and adults (children: OR=22.00, P<0.001; adults: OR=172.12, P<0.001). The median post-surgery survival was 22 months for children and 24 months for adults.

Conclusion: There was no correlation between sex and poorer outcomes. Mortality at one month and one year after transplantation was associated with the following risk factors: the use of ECMO, reoperation for bleeding, defibrillation following cross-clamp removal, and Intensive Care Unit (ICU) stay. Readmission, on the other hand, had a weak protective effect.

Keywords: Heart transplantation; Mortality; Risk factors; Survival.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Survival probability curve of children and adult patients is indicated over time by age groups.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Veen KM, Zijderhand CF, Caliskan K, Schoonen T, Mokhles MM, Bekkers JA, et al. Biatrial vs Bicaval orthotopic Heart Transplantation: A Systematic Review and Meta-Analysis. Determinants of outcome in patients with tricuspid valve. 2020:271. - PubMed
    1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–200. doi: 10.1093/eurheartj/ehw128. - DOI - PubMed
    1. Jasseron C, Lebreton G, Cantrelle C, Legeai C, Leprince P, Flecher E, et al. Impact of Heart Transplantation on Survival in Patients on Venoarterial Extracorporeal Membrane Oxygenation at Listing in France. Transplantation. 2016;100:1979–87. doi: 10.1097/TP.0000000000001265. - DOI - PubMed
    1. Taylor DO, Stehlik J, Edwards LB, Aurora P, Christie JD, Dobbels F, et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult Heart Transplant Report-2009. J Heart Lung Transplant. 2009;28:1007–22. doi: 10.1016/j.healun.2009.08.014. - DOI - PubMed
    1. Bhatia DS, Bowen JC, Money SR, Van Meter CH, Jr., McFadden PM, Kot JB, et al. The incidence, morbidity, and mortality of surgical procedures after orthotopic heart transplantation. Ann Surg. 1997;225:686–93-4. doi: 10.1097/00000658-199706000-00006. [ PMC Free Article ] - DOI - PMC - PubMed

MeSH terms