Primary graft dysfunction after heart transplantation: Incidence, trends, and associated risk factors

• DOI: 10.1111/ajt.14588
• Publication Date: 2017-11-14T16:37:34Z
• Authors: Alina Nicoara; David Ruffin; Mary Cooter; Chetan B. Patel; Annemarie Thompson; Jacob N. Schroder; Mani A. Daneshmand; Adrian F. Hernandez; Joseph G. Rogers; Mihai V. Podgoreanu; Madhav Swaminathan; Adam Kretzer; Mark Stafford-Smith; Carmelo A. Milano; Raquel R. Bartz
• Keywords: Demographics

Changes in heart transplantation (HT) donor and recipient demographics may influence the incidence of primary graft dysfunction (PGD). We conducted a retrospective study to evaluate PGD incidence, trends, associated risk factors by analyzing consecutive adult patients who underwent HT between January 2009 December 2014 at our institution. Patients were categorized as having using International Society for Heart & Lung Transplantation (ISHLT)-defined criteria. Variables, including clinical demographic characteristics donors recipients, selected assess their independent association with PGD. A time-trend analysis was performed over period. Three-hundred seventeen met inclusion Left ventricular PGD, right or both, observed 99 (31%). Risk independently included ischemic time, African American race, amiodarone treatment. Over period, there no change incidence; however, an increase pretransplantation use amiodarone. The rate 30-day mortality significantly elevated those versus without (6.06% vs 0.92%, P = .01). Despite recent advancements, remains high. Understanding allow implementation targeted therapeutic interventions.