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Open Access 01-12-2008 | Research article

Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure

Authors: Pavan Atluri, William Hiesinger, Robert C Gorman, Alberto Pochettino, Mariell Jessup, Michael A Acker, Rohinton J Morris, Y Joseph Woo

Published in: Journal of Cardiothoracic Surgery | Issue 1/2008

Abstract

Background

Although orthotopic heart transplantation has been an effective treatment for end-stage heart failure, the incidence of allograft failure has increased, necessitating treatment options. Cardiac retransplantation remains the only viable long-term solution for end-stage cardiac allograft failure. Given the limited number of available donor hearts, the long term results of this treatment option need to be evaluated.

Methods

709 heart transplants were performed over a 20 year period at our institution. Repeat cardiac transplantation was performed in 15 patients (2.1%). A retrospective analysis was performed to determine the efficacy of cardiac retransplantation. Variables investigated included: 1 yr and 5 yr survival, length of hospitalization, post-operative complications, allograft failure, recipient and donor demographics, renal function, allograft ischemic time, UNOS listing status, blood group, allograft rejection, and hemodynamic function.

Results

Etiology of primary graft failure included transplant arteriopathy (n = 10), acute rejection (n = 3), hyperacute rejection (n = 1), and a post-transplant diagnosis of metastatic melanoma in the donor (n = 1). Mean age at retransplantation was 45.5 ± 9.7 years. 1 and 5 year survival for retransplantation were 86.6% and 71.4% respectively, as compared to 90.9% and 79.1% for primary transplantation. Mean ejection fraction was 67.3 ± 12.2% at a mean follow-up of 32.6 ± 18.5 mos post-retransplant; follow-up biopsy demonstrated either ISHLT grade 1A or 0 rejection (77.5 ± 95.7 mos post-transplant).

Conclusion

Cardiac retransplantation is an efficacious treatment strategy for cardiac allograft failure.

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Title: Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure
Authors: Pavan Atluri
William Hiesinger
Robert C Gorman
Alberto Pochettino
Mariell Jessup
Michael A Acker
Rohinton J Morris
Y Joseph Woo
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2008
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/1749-8090-3-26

At a glance: The STEP trials

Springer Medicine

Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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