TY - JOUR
T1 - When and why do heart transplant recipients die? A 7 year experience of 1068 cardiac transplants
AU - Gallo, Pietro
AU - Baroldi, Giorgio
AU - Thiene, Gaetano
AU - Agozzino, Lucio
AU - Arbustini, Eloisa
AU - Bartoloni, Giovanni
AU - Bonacina, Edgardo
AU - Bosman, Cesare
AU - Catani, Gualtiero
AU - Cocco, Patrizia
AU - di Gioia, Cira
AU - Motta, Teresio
AU - Pucci, Angela
AU - Rocco, Maurizio
PY - 1993/11
Y1 - 1993/11
N2 - This mortality study deals with the 1068 heart transplants (1054 patients) performed in Italian Units from November 1985 to April 1992. The death rate was 19.7% and the actuarial survival was 89% at 1 month, 83% at 1 year and 74% at 6.5 years. Recipients who died had been less often transplanted for dilated cardiomyopathy, were older (44.1 vs. 41.7 years) and more often male (84.5 vs. 72.7%). Analysis of the causes of death was restricted to orthotopic transplantations (1029/1068 procedures, 195/208 deaths). Deaths were grouped within four intervals: peri-operative (≤1 month, 50.0% of deaths), early (>1 month ≤3 months, 17.2%), intermediate (>3 months ≤2 years, 22.6%) and late (>2 years, 10.2%). The prime causes of death were mostly postoperative graft failure (whose effects brought about 64% of peri-operative deaths, 28% of early and 7% of intermediate deaths), post-operative complications (10% of peri-operative deaths), acute rejection (10% of total deaths, distributed in all the periods), graft arteriopathy (6% of early, 36% of intermediate and 58% of late deaths), infections (17% of deaths, occurring in all periods but late) and malignant tumours (7% of deaths), lymphomas being the first to occur and Kaposi's sarcoma occuring only in the intermediate period. Repeat transplantation had a poor outcome (death rate 71.4%), two-thirds of the re-transplanted patients' deaths being due to early graft failure and a third to late relapsing graft vasculopathy.
AB - This mortality study deals with the 1068 heart transplants (1054 patients) performed in Italian Units from November 1985 to April 1992. The death rate was 19.7% and the actuarial survival was 89% at 1 month, 83% at 1 year and 74% at 6.5 years. Recipients who died had been less often transplanted for dilated cardiomyopathy, were older (44.1 vs. 41.7 years) and more often male (84.5 vs. 72.7%). Analysis of the causes of death was restricted to orthotopic transplantations (1029/1068 procedures, 195/208 deaths). Deaths were grouped within four intervals: peri-operative (≤1 month, 50.0% of deaths), early (>1 month ≤3 months, 17.2%), intermediate (>3 months ≤2 years, 22.6%) and late (>2 years, 10.2%). The prime causes of death were mostly postoperative graft failure (whose effects brought about 64% of peri-operative deaths, 28% of early and 7% of intermediate deaths), post-operative complications (10% of peri-operative deaths), acute rejection (10% of total deaths, distributed in all the periods), graft arteriopathy (6% of early, 36% of intermediate and 58% of late deaths), infections (17% of deaths, occurring in all periods but late) and malignant tumours (7% of deaths), lymphomas being the first to occur and Kaposi's sarcoma occuring only in the intermediate period. Repeat transplantation had a poor outcome (death rate 71.4%), two-thirds of the re-transplanted patients' deaths being due to early graft failure and a third to late relapsing graft vasculopathy.
KW - Allograft rejection
KW - Cardiac transplantation
KW - Graft arteriopathy
KW - Mortality
KW - Tumours
UR - http://www.scopus.com/inward/record.url?scp=0027181147&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027181147&partnerID=8YFLogxK
U2 - 10.1007/BF01606453
DO - 10.1007/BF01606453
M3 - Article
C2 - 8333149
AN - SCOPUS:0027181147
VL - 422
SP - 453
EP - 458
JO - Virchows Archiv - A Pathological Anatomy and Histopathology
JF - Virchows Archiv - A Pathological Anatomy and Histopathology
SN - 0945-6317
IS - 6
ER -