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Posttransplant Pulmonary Hypertension Is Correlated With Acute Rejection and Death Among Cardiac Transplant Recipients: A Single Center Study.
- Source :
-
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation [Exp Clin Transplant] 2018 Mar; Vol. 16 Suppl 1 (Suppl 1), pp. 80-84. - Publication Year :
- 2018
-
Abstract
- Objectives: Endomyocardial biopsy sampling is used to check acute rejection after cardiac transplant. However, it may lead to tricuspid valve injury and cardiac perforation; therefore, less invasive tools may be useful. Right heart catheterization provides valuable information about cardiac hemodynamics. Herein, we aimed to determine the correlation of right heart catheterization parameters with acute rejection and death during cardiac transplant follow-up.<br />Materials and Methods: We retrospectively evaluated follow-up right heart catheterization and endomyocardial biopsy results from 47 adult patients who underwent cardiac transplant at Başkent University Faculty of Medicine between 2004 and 2016. Right heart catheterization parameters were compared between deceased and surviving patients and were correlated with acute cellular and humoral rejection. Averaged right heart catheterization parameters were correlated with death. We used Cox regression analysis to determine risk of death and acute cellular rejection and Kaplan-Meier survival analysis to determine any survival differences associated with pulmonary hypertension.<br />Results: There were 47 patients (38 males, 9 females) with a mean age of 44 ± 10 years at transplant. In our patient group, 18 patients (38.3%) died at a median time of 11.2 months. Ninety endomyocardial biopsy samples (22.1%) showed cellular rejection, and 61 samples (4.5%) showed humoral rejection. The deceased patients had significantly greater mean and systolic pulmonary artery pressures, which were significantly correlated with acute cellular rejection. Death was significantly correlated with averaged values of mean and systolic pulmonary artery pressures. Our Cox regression analysis revealed that pulmonary hypertension was significantly associated with risk of death and acute cellular rejection. A Kaplan-Meier survival analysis revealed that pulmonary hypertension was associated with a significantly lower median survival.<br />Conclusions: Pulmonary artery pressures are significantly correlated with acute cellular rejection and death after cardiac transplant. Pulmonary hypertension significantly increases the risk of death and shortens survival after cardiac transplant.
- Subjects :
- Acute Disease
Adult
Arterial Pressure
Biopsy
Cardiac Catheterization
Cause of Death
Chi-Square Distribution
Female
Graft Rejection diagnosis
Graft Rejection immunology
Graft Rejection mortality
Heart Transplantation mortality
Hospitals, University
Humans
Hypertension, Pulmonary diagnosis
Hypertension, Pulmonary mortality
Hypertension, Pulmonary physiopathology
Immunity, Cellular
Immunity, Humoral
Kaplan-Meier Estimate
Male
Middle Aged
Odds Ratio
Proportional Hazards Models
Pulmonary Artery physiopathology
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Turkey
Graft Rejection etiology
Heart Transplantation adverse effects
Hypertension, Pulmonary etiology
Subjects
Details
- Language :
- English
- ISSN :
- 2146-8427
- Volume :
- 16 Suppl 1
- Issue :
- Suppl 1
- Database :
- MEDLINE
- Journal :
- Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 29527998
- Full Text :
- https://doi.org/10.6002/ect.TOND-TDTD2017.O33