Transplantation proceedings · 2025
Determinants of Short-Term Survival After Heart Transplantation in Patients Bridged to Transplant With Left Ventricular Assist Device.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Şenkaya Suat, Kahraman Ümit, Kapkın Ayşen Yaprak, Balcıoğlu Özlem, Nalbantgil Sanem, Engin Çağatay, Yağdı Tahir, Özbaran Mustafa
Аннотация
BACKGROUND: The bridge to heart transplantation has been the subject of intense debate. This study aimed to determine the factors affecting early survival after bridge to heart transplantation.
METHODS: Between 2011 and 2019, patients who underwent a bridge to heart transplantation in a single center were retrospectively scanned. Demographics, complications of left ventricular assist device (LVAD), cardiopulmonary bypass (CPB), and cross-clamp duration, use of blood products, length of ventricular assist device (VAD) support, post-transplant hospital stay, post-transplant complications, and in-hospital mortality rates were recorded.
RESULTS: Patients (n = 60) were divided into 2 groups; patients with 30-day mortality (group 1, n = 10) and those with survival longer than 30 days (group 2, n = 50). The patients in group 1 were found to be older (P = .009), supported for a longer duration (P = .027), have higher International Normalized Ratio (INR) levels (P = .025), and have device-specific infection more commonly (P = .003). Cardiac ischemia (P = .013) and CPB (P = .006) durations were longer in group 1. Use of blood products and nitric oxide (NO) was more frequent in group 1 (P < .05). Post-transplantation complications (stroke, sepsis, kidney failure, arrhythmia, need for intra-aortic balloon pump [IABP], and short-term mechanical circulatory support [MCS]) were significantly more common in group 1 patients (P < .05). Blood products (0.920 for red blood cells, 0.901 for fresh frozen plasma, and 0.885 for platelets), postoperative high creatinine (0.817) and lactate (0.715), and device-specific infection (0.686) had the highest area under the curve values in the receiver operating characteristic (ROC).
CONCLUSIONS: Bridge to transplantation has its own challenges of being a reoperation under high INR levels. Recurrent infection attacks and an inflammatory state may be limiting the healing process. Device-specific infection may be a major reason for early mortality whereas it is also a major indication for urging heart transplantation.
METHODS: Between 2011 and 2019, patients who underwent a bridge to heart transplantation in a single center were retrospectively scanned. Demographics, complications of left ventricular assist device (LVAD), cardiopulmonary bypass (CPB), and cross-clamp duration, use of blood products, length of ventricular assist device (VAD) support, post-transplant hospital stay, post-transplant complications, and in-hospital mortality rates were recorded.
RESULTS: Patients (n = 60) were divided into 2 groups; patients with 30-day mortality (group 1, n = 10) and those with survival longer than 30 days (group 2, n = 50). The patients in group 1 were found to be older (P = .009), supported for a longer duration (P = .027), have higher International Normalized Ratio (INR) levels (P = .025), and have device-specific infection more commonly (P = .003). Cardiac ischemia (P = .013) and CPB (P = .006) durations were longer in group 1. Use of blood products and nitric oxide (NO) was more frequent in group 1 (P < .05). Post-transplantation complications (stroke, sepsis, kidney failure, arrhythmia, need for intra-aortic balloon pump [IABP], and short-term mechanical circulatory support [MCS]) were significantly more common in group 1 patients (P < .05). Blood products (0.920 for red blood cells, 0.901 for fresh frozen plasma, and 0.885 for platelets), postoperative high creatinine (0.817) and lactate (0.715), and device-specific infection (0.686) had the highest area under the curve values in the receiver operating characteristic (ROC).
CONCLUSIONS: Bridge to transplantation has its own challenges of being a reoperation under high INR levels. Recurrent infection attacks and an inflammatory state may be limiting the healing process. Device-specific infection may be a major reason for early mortality whereas it is also a major indication for urging heart transplantation.