Abstract 12848: Infections Requiring Hospitalization in Patients One Year Post Heart Transplant

• DOI: 10.1161/circ.146.suppl_1.12848
• Publication Date: 2023-06-15T15:53:36Z
• Authors: Max Jason; Rodolfo Alpizar-R...; Rohith Palli; Jeffrey Alexis; Anna Sorensen; Christine Hay

Introduction: Immunosuppression of heart transplant (txp) recipients increases risk of infection. This study will identify the most common pathogens and characterize the most at-risk patients.

Methods: We performed a single center retrospective cohort study at the University of Rochester. Demographics, pretransplant characteristics, and infections requiring rehospitalization were obtained (table 1) from electronic records of patients who received a txp from January 1, 2011 through July 1, 2020. Chi-square, t-test, and Wilcoxon rank-sum test assessed association between mortality, infection risk and other variables.

Results: We identified 132 patients who received txp but excluded 4 due to incomplete data, 10 (7.6%) patients died during index admission while 12 (9.4%) more patients died in the year following their txp. Infections occurring 1 month post txp were associated with mortality (p-adj 0.026). Prior sternotomies (n=65, 50.8%) were associated with both mortality and bacterial infection (p-adj <0.01). EBV mismatch (n= 7, 5.5%) was associated with infections during months 7-12 post-txp (p-adj 0.027). Unknown pathogens (20) were the most common cause of rehospitalization followed by Pseudomonas (13) (Fig 1).

Conclusions: Our study identifies patient risk of rehospitalization due to infection in the year following txp. Prior sternotomies were associated with worse outcomes. We hypothesize this is due to scarring and is worth studying prospectively. Patients with EBV mismatch had higher rates of infections in months 7-12, a finding not previously described. There was higher mortality associated with infections that required hospitalization in the first month.