التفاصيل البيبلوغرافية
| العنوان: |
Adult Combined Heart-Liver Transplantation: The United States Experience. |
| المؤلفون: |
Alexopoulos, Sophoclis P.1 sopho.alexopoulos@vumc.org, Kelly Wu, W.1, Ziogas, Ioannis A.1, Matsuoka, Lea K.1, Rauf, Muhammad A.1, Izzy, Manhal2, Perri, Roman2, Schlendorf, Kelly H.3, Menachem, Jonathan N.3, Shah, Ashish S.4 |
| المصدر: |
Transplant International. 1/4/2022, Vol. 35, p1-8. 8p. |
| مصطلحات موضوعية: |
*LOG-rank test, *CONGENITAL heart disease, *OVERALL survival, *ADULTS, *SURVIVAL analysis (Biometry), *ARTIFICIAL hearts, *VENTRICULAR ejection fraction |
| مستخلص: |
Background: We aimed to review the indications and outcomes of adults undergoing combined heart-liver transplantation (CHLT) in the US using national registry data. Methods: Adult (≥18 years) CHLT recipients in the United Network for Organ Sharing database were included (09/1987–09/2020; era 1 = 1989–2000, era 2 = 2001–2010, era 3 = 2011–2020). Survival analysis was conducted by means of Kaplan-Meier method, logrank test, and Cox regression. Results: We identified 369 adults receiving CHLT between 12/1989–08/2020. The number of adult CHLT recipients (R² = 0.75, p < 0.001) and centers performing CHLT (R2 = 0.80, p < 0.001) have increased over the study period. The most common cardiac diagnosis in the first two eras was restrictive/infiltrative cardiomyopathy, while the most common in era 3 was congenital heart disease (p = 0.03). The 1-, 3-, and 5-years patient survival was 86.8, 80.1, and 77.9%, respectively. In multivariable analysis, recipient diabetes [adjusted hazard ratio (aHR) = 2.35, 95% CI: 1.23–4.48], CHLT between 1989-2000 compared with 2011–2020 (aHR = 5.00, 95% CI: 1.13–22.26), and sequential-liver first CHLT compared with sequential-heart first CHLT (aHR = 2.44, 95% CI: 1.15–5.18) were associated with increased risk of mortality. Higher left ventricular ejection fraction was associated with decreased risk of mortality (aHR = 0.96, 95% CI: 0.92–0.99). Conclusion: CHLT is being increasingly performed with evolving indications. Excellent outcomes can be achieved with multidisciplinary patient and donor selection and surgical planning. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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