Analysis of risk factors for early and late outcomes in heart transplantation patients: experience in heart transplantation from a single centre
10.3760/cma.j.issn.0254-1785.2010.08.003
- VernacularTitle:心脏移植近远期疗效危险因素分析——从单中心经验看我国心脏移植特点和现状
- Author:
Shengshou HU
;
Yunhu SONG
;
Wei WANG
;
Jie HUANG
;
Zhongkai LIAO
;
Lei FENG
;
Dong YIN
;
Lihuan LI
;
Mingzheng LIU
;
Zhe ZHENG
;
Keming YANG
;
Sheng LIU
;
Zhiyuan LI
;
Jun ZHU
;
Jian ZHANG
;
Ping LIU
;
Yong WANG
;
Li SHI
;
Jianli QIU
- Publication Type:Journal Article
- Keywords:
Heart transplantation;
Mortality;
Risk factors;
Postoperative complications
- From:
Chinese Journal of Organ Transplantation
2010;31(8):454-458
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize risk factors for clinical outcomes in heart transplantation patients, evaluate the characters of Chinese patients by comparing with international data, and introduce new clinical strategies. Methods We performed 200 heart transplantations from Jun. 2004 to May 2010. The clinical information was recorded and all patients were followed up. By analyzing 160 patients with a follow-up period of more than one year, we summarized clinical outcomes and risk factors of early and late results of heart transplant patients. Results Of 160 patients, 8. 1 % received postoperative extracorporeal membrane oxygenation (ECMO) support and 10% continuous renal replacement therapy. In 550 cases/times of endomyocardial biopsies, the incidence of rejection with grades more than Ⅱ (concluding grade Ⅱ ) was 14. 9%. In-hospital mortality was 3. 8%. Smoking,preoperative diastolic pulmonary arterial pressure, PAWP, total serum protein level and albumin level were risk factors of peri-operative mortality, and preoperative diastolic pulmonary arterial pressure,primary heart diseases, pulmonary hypertension and implantations of ICD, MCS and ECMO were risk factors of late mortality. Postoperatively, 1-, 3- and 5-year survival rate was 94. 4%, 91.9% and 88. 8%, respectively. Compared with UNOS data, the rate of primary heart diseases, pulmonary hypertension, and implantation of ICD, MCS and ECMO were different, and the long-term survival rate of 160 patients was higher than that reported by ISHLT. Conclusion The risk factors of mortality of Chinese heart transplant patients are different with their counterparts from western countries. Our corresponding peri-operative treatments and clinical strategies have produced satisfactory clinical outcomes.
