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Primary Graft Dysfunction After Isolated Heart Transplantation - Incidence, Risk Factors, and Clinical Implications Based on a Single-Center Experience -

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Abstract
Background: Since the international consensus on primary graft dysfunction (PGD) following heart transplantation (HT) was reported in 2014, few clinical studies have been reported. We aimed to analyze the incidence, predictive factors, and clinical implications of PGD following the International Society of Heart and Lung Transplant criteria in a single center.

Methods and Results: This study enrolled 570 consecutive adult patients undergoing isolated HT between November 1992 and December 2017. Under a new set of criteria, PGD-left ventricle (PGD-LV) occurred in 35 patients (6.1%; mild, n=1 [0.2%]; moderate, n=14 [2.5%]; severe, n=20 [3.5%]), whereas PGD-right ventricle (PGD-RV) occurred in 3 (0.5%). Multivariable analysis demonstrated that preoperative admission (odds ratio [OR] 4.20; 95% confidence interval [CI] 1.24-14.26; P=0.021), preoperative extracorporeal membrane oxygenation (OR 4.03; 95% CI 1.75-9.26; P=0.001), and prolonged total ischemic time (OR 1.09; 95% CI 1.02-1.15; P=0.006) were significant predictors of moderate to severe PGD-LV. Moderate to severe PGD-LV was an independent and significant risk factor for early death (OR 55.64; 95% CI 11.65-265.73; P<0.001), with its effects extending up to 3 months after HT.

Conclusions: Moderate to severe PGD-LV, as defined by the new guidelines, is an important predictor of early mortality, with effects extending up to 3 months after HT. Efforts to reduce the occurrence of moderate to severe PGD-LV may lead to better outcomes.
Author(s)
이연주김호진김재중김민석이상은윤태진이재원정성호
Issued Date
2021
Type
Article
Keyword
Heart transplantationPrimary graft dysfunctionRisk factors
DOI
10.1253/circj.CJ-20-0960
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8773
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2515070199&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Primary%20Graft%20Dysfunction%20After%20Isolated%20Heart%20Transplantation%20-%20Incidence,%20Risk%20Factors,%20and%20Clinical%20Implications%20Based%20on%20a%20Single-Center%20Experience%20-&amp;offset=0&amp;pcAvailability=true
Publisher
CIRCULATION JOURNAL
Location
일본
Language
영어
ISSN
1346-9843
Citation Volume
85
Citation Number
9
Citation Start Page
1451
Citation End Page
1459
Appears in Collections:
Medicine > Medicine
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