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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
GOMEZ-MESA, Juan E. et al. Factors associated with mortality in the first year post-cardiac transplantation. Rev. Colomb. Cardiol. [online]. 2020, vol.27, n.4, pp.223-231. Epub June 18, 2021. ISSN 0120-5633. https://doi.org/10.1016/j.rccar.2019.09.007.
Introduction:
The survival rate in the first year after heart transplant is between 81% and 85%. The main causes of mortality are infections and failure of the graft.
Objective:
To determine the risk factors associated with mortality at one year post- cardiac transplant in a high complexity hospital in south-west Colombia.
Methods:
A retrospective cohort study was performed on patients with a heart transplant carried out between 1996 and 2015. Information was obtained on the characteristics of the donor, recipient, and surgical procedure. A Cox regression was performed, with the event of interest being mortality in the first year of follow-up. In the multivariate analysis, variables were included that had a P≤ .20 and clinical significance.
Results:
The study included a total of 158 patients, with a median age of 50 years (IQR: 39-57), of whom 76% were males. The most common origin was idiopathic heart failure (45%). The median time of ischaemia was 187 minutes (IQR: 142-300). The mortality was 24% and was mainly due to infections (29%). There were factors associated with the congenital heart failure mortality such as origin of heart failure (P = .048), history of diabetes mellitus (P = .001), previous cardiac surgery (P = .023), ischaemia time greater than 150 minutes (P = .038), and the male recipient / female donor ratio (P = .022).
Conclusions:
The factors associated with higher mortality in the first year post-cardiac transplant were: origin of heart failure due to congenital heart disease, history of diabetes mellitus, previous cardiac surgery, the male recipient / female donor ratio, and an ischaemia time greater than 150 minutes.
Keywords : Heart transplant; Mortality; Risk factors.