Journals / Turkish Journal of Clinics and Laboratory / 2022 / Cilt: 13 - Sayı: 3
Kalp nakil olan hastaların hayatta kalması ile ilgili faktörler
- Pages
- 366–372
- DOI
- —
Abstract
Aim: Heart transplantation is currently considered the optimal surgical approach for the treatment of refractory heart failure, as it offers a higher likelihood of survival as well as significant improvements to quality of life. We aim to identify factors that relate to post-transplantation survival among patients who received a cardiac transplantation. Material and Methods: We retrospectively included all cardiac transplant recipients who underwent cardiac transplant operations at the Başkent University Faculty of Medicine between February 1, 2003 and December 1, 2019. We examined various demographic and clinical factors. This study was approved by the Başkent University Medical and Health Sciences Research Board (Project no KA20 / 326) and supported by the Başkent University Research Fund. The principles of the Declaration of Helsinki were complied with during the study. Results: A total of 99 patients were involved in the study. The mean age was 41.65 ± 14.89 years. The underlying cardiac condition for cardiac transplantation was ischemic dilated cardiomyopathy in 20 patients (20.2%),non-ischemic dilated cardiomyopathy in 66 patients (66.7%),restrictive cardiomyopathy in five patients (5.1%),myocarditis in one patient (1.0%),and another cause in seven patients (7.1%). Binary logistic regression analysis indicates that transplant rejection was the sole independent predictor of mortality. Conclusion: The survival of cardiac transplant recipients is significantly correlated to transplant rejection and patient age. However, we observed a significant correlation between survival status and hyperlipoproteinemia. Furthermore, the mortality rates among patients with cellular, humoral, and cellular-humoral diseases were found to be lower than the mortality rate of patients without rejection. KEYWORDS: heart transplantation; transplantation; graft rejection; survival; heart failure; mortality
Özet
In summary, our study suggests no significant correlation between survival status and diabetes mellitus, between survival status and arterial hypertension, or between survival and the presence of cancer. However, we observed a significant correlation between survival status and hyperlipoproteinemia. Furthermore, the mortality rates among patients with cellular, humoral, and cellular-humoral diseases were found to be lower than the mortality rate of patients without rejection. Thus, a statistically significant correlation between survival status and rejection is evident. The discrepancy in survival status in relation to the age of patients was also significant. These findings highlight the importance of preventing hyperlipoproteinemia to support a long and healthy life. In addition, to reduce mortality, the likelihood of rejection should be minimized as much as possible. Finally, each potential recipient should be evaluated in terms of individual risk and benefit from the procedure. Variables that contribute to long-term mortality may include recipient and donor age, recipient and donor body mass index, lifestyle, length of hospital stay, and time of ischemia. More comprehensive studies are needed for the variables that contribute to long-term mortality. This is one of the limitations of our study.