Heart transplant program at IRCCS-ISMETT: Impact of mechanical circulatory support on pre- and post -transplant survival

Research output: Contribution to journalArticle

Abstract

Background Heart transplantation (HTx) improves the quality of life and survival in patients affected by end-stage heart failure. The purpose of the current study is to present the patients' clinical data and results of HTx in a single Center of Sicily. Focus on survival after pre and post HTx mechanical circulatory support use will be performed. Methods. 133 HTx were done from 2004 to the end of 2015.The average donor age was 34 ± 13.5 years and the proportion of male donors was 67%. Percentage of use of mechanical circulatory support to bridge patients to HTx was 18%. Results. Overall pre-transplant mechanical circulatory support was not correlated to worse post-transplant prognosis, p = 0.757. Severe primary early graft failure requiring extra corporeal membrane oxygenator support strongly impact the early mortality after heart transplantation (p <0.001). Conclusions. The results of HTx at ISMETT are comparable to those reported in high volume Italian transplant centers as well as in the ISHLT registry. The favorable outcome can be related to focus on multidisciplinary approach, strict recipients' selection and young donor population. Post HTx mechanical circulatory support use in general remains associated with worse post-transplant outcomes. This does not apply to pre-op mechanical circulatory support population.

Original languageEnglish
Pages (from-to)358-361
Number of pages4
JournalInternational Journal of Cardiology
Volume219
DOIs
Publication statusPublished - Sep 15 2016

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Transplants
Heart Transplantation
Tissue Donors
Membrane Oxygenators
Sicily
Donor Selection
Survival
Population
Registries
Heart Failure
Quality of Life
Mortality

Keywords

  • Coronary allograft disease
  • Early graft failure
  • Heart failure
  • Heart transplantation
  • Mechanical circulatory support

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{f4d3cacdf86f40dbbc9e6cf152754b42,
title = "Heart transplant program at IRCCS-ISMETT: Impact of mechanical circulatory support on pre- and post -transplant survival",
abstract = "Background Heart transplantation (HTx) improves the quality of life and survival in patients affected by end-stage heart failure. The purpose of the current study is to present the patients' clinical data and results of HTx in a single Center of Sicily. Focus on survival after pre and post HTx mechanical circulatory support use will be performed. Methods. 133 HTx were done from 2004 to the end of 2015.The average donor age was 34 ± 13.5 years and the proportion of male donors was 67{\%}. Percentage of use of mechanical circulatory support to bridge patients to HTx was 18{\%}. Results. Overall pre-transplant mechanical circulatory support was not correlated to worse post-transplant prognosis, p = 0.757. Severe primary early graft failure requiring extra corporeal membrane oxygenator support strongly impact the early mortality after heart transplantation (p <0.001). Conclusions. The results of HTx at ISMETT are comparable to those reported in high volume Italian transplant centers as well as in the ISHLT registry. The favorable outcome can be related to focus on multidisciplinary approach, strict recipients' selection and young donor population. Post HTx mechanical circulatory support use in general remains associated with worse post-transplant outcomes. This does not apply to pre-op mechanical circulatory support population.",
keywords = "Coronary allograft disease, Early graft failure, Heart failure, Heart transplantation, Mechanical circulatory support",
author = "Raffa, {Giuseppe Maria} and {Di Gesaro}, Gabriele and Sergio Sciacca and Fabio Tuzzolino and Marco Turrisi and Calogero Falletta and Chiara Min{\`a} and Giuseppe Romano and Giuseppe Vitale and Giovanna Panarello and Francesco Clemenza and Michele Pilato",
year = "2016",
month = "9",
day = "15",
doi = "10.1016/j.ijcard.2016.06.056",
language = "English",
volume = "219",
pages = "358--361",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Heart transplant program at IRCCS-ISMETT

T2 - Impact of mechanical circulatory support on pre- and post -transplant survival

AU - Raffa, Giuseppe Maria

AU - Di Gesaro, Gabriele

AU - Sciacca, Sergio

AU - Tuzzolino, Fabio

AU - Turrisi, Marco

AU - Falletta, Calogero

AU - Minà, Chiara

AU - Romano, Giuseppe

AU - Vitale, Giuseppe

AU - Panarello, Giovanna

AU - Clemenza, Francesco

AU - Pilato, Michele

PY - 2016/9/15

Y1 - 2016/9/15

N2 - Background Heart transplantation (HTx) improves the quality of life and survival in patients affected by end-stage heart failure. The purpose of the current study is to present the patients' clinical data and results of HTx in a single Center of Sicily. Focus on survival after pre and post HTx mechanical circulatory support use will be performed. Methods. 133 HTx were done from 2004 to the end of 2015.The average donor age was 34 ± 13.5 years and the proportion of male donors was 67%. Percentage of use of mechanical circulatory support to bridge patients to HTx was 18%. Results. Overall pre-transplant mechanical circulatory support was not correlated to worse post-transplant prognosis, p = 0.757. Severe primary early graft failure requiring extra corporeal membrane oxygenator support strongly impact the early mortality after heart transplantation (p <0.001). Conclusions. The results of HTx at ISMETT are comparable to those reported in high volume Italian transplant centers as well as in the ISHLT registry. The favorable outcome can be related to focus on multidisciplinary approach, strict recipients' selection and young donor population. Post HTx mechanical circulatory support use in general remains associated with worse post-transplant outcomes. This does not apply to pre-op mechanical circulatory support population.

AB - Background Heart transplantation (HTx) improves the quality of life and survival in patients affected by end-stage heart failure. The purpose of the current study is to present the patients' clinical data and results of HTx in a single Center of Sicily. Focus on survival after pre and post HTx mechanical circulatory support use will be performed. Methods. 133 HTx were done from 2004 to the end of 2015.The average donor age was 34 ± 13.5 years and the proportion of male donors was 67%. Percentage of use of mechanical circulatory support to bridge patients to HTx was 18%. Results. Overall pre-transplant mechanical circulatory support was not correlated to worse post-transplant prognosis, p = 0.757. Severe primary early graft failure requiring extra corporeal membrane oxygenator support strongly impact the early mortality after heart transplantation (p <0.001). Conclusions. The results of HTx at ISMETT are comparable to those reported in high volume Italian transplant centers as well as in the ISHLT registry. The favorable outcome can be related to focus on multidisciplinary approach, strict recipients' selection and young donor population. Post HTx mechanical circulatory support use in general remains associated with worse post-transplant outcomes. This does not apply to pre-op mechanical circulatory support population.

KW - Coronary allograft disease

KW - Early graft failure

KW - Heart failure

KW - Heart transplantation

KW - Mechanical circulatory support

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JO - International Journal of Cardiology

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