Yonsei medical journal · 2026
Risk Analysis of Waiting-List Mortality in Heart Transplantation: A Multicenter Study in Korea.
СтатьяМногоцентровое исследованиеНазвание 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.
Kim Jung-Hwan, Cho Yang Hyun, Sohn Suk Ho, Hwang Ho Young, Jung Sung Ho, Youn Young-Nam
Аннотация
PURPOSE: There are few national studies of waiting-list mortality for heart transplantation (HT) in Korea. Our multicenter study examined mortality on the HT waiting list and its associated risk factors.
MATERIALS AND METHODS: We retrospectively analyzed 1101 consecutive patients who were wait-listed for HT between 2012 and 2017 in four centers. Time on the HT waiting list was defined as the time from initial wait-listing to delisting due to HT, death, or recovery. Subjects were censored at the time of transplantation or recovery.
RESULTS: Of the whole cohort, 327 (29.7%) patients needed mechanical circulatory support (MCS) while on the waiting list, 314 (28.5%) were treated with extracorporeal membrane oxygenation (ECMO) as a bridge, and 13 (1.2%) were treated with a ventricular assist device (VAD) as a bridge. The waiting-list survival rate for ECMO-bridged patients was significantly lower than that for VAD-bridged or non-MCS-bridged patients. The waiting-list survival rate for patients with a status of 0 or 1 was significantly lower than for patients with a status of 2 or 3. Multivariate analysis revealed that the independent risk factors for waiting-list mortality were congenital heart disease and restrictive cardiomyopathy compared with dilated cardiomyopathy, status 0 compared with status 2 and 3, low hemoglobin, history of ventricular arrhythmia, high MELD-XI score, and ECMO bridging during the waiting period.
CONCLUSION: This study showed that ECMO as a bridge to transplantation and status 0 were associated with significantly higher waiting-list mortality. Advanced end-organ damage at the time of listing was also found to be an independent risk factor for waiting-list mortality.
MATERIALS AND METHODS: We retrospectively analyzed 1101 consecutive patients who were wait-listed for HT between 2012 and 2017 in four centers. Time on the HT waiting list was defined as the time from initial wait-listing to delisting due to HT, death, or recovery. Subjects were censored at the time of transplantation or recovery.
RESULTS: Of the whole cohort, 327 (29.7%) patients needed mechanical circulatory support (MCS) while on the waiting list, 314 (28.5%) were treated with extracorporeal membrane oxygenation (ECMO) as a bridge, and 13 (1.2%) were treated with a ventricular assist device (VAD) as a bridge. The waiting-list survival rate for ECMO-bridged patients was significantly lower than that for VAD-bridged or non-MCS-bridged patients. The waiting-list survival rate for patients with a status of 0 or 1 was significantly lower than for patients with a status of 2 or 3. Multivariate analysis revealed that the independent risk factors for waiting-list mortality were congenital heart disease and restrictive cardiomyopathy compared with dilated cardiomyopathy, status 0 compared with status 2 and 3, low hemoglobin, history of ventricular arrhythmia, high MELD-XI score, and ECMO bridging during the waiting period.
CONCLUSION: This study showed that ECMO as a bridge to transplantation and status 0 were associated with significantly higher waiting-list mortality. Advanced end-organ damage at the time of listing was also found to be an independent risk factor for waiting-list mortality.