Universität zu Köln

Farag, Mina, Nikolic, Marina, Arif, Rawa, Schmack, Bastian, Sabashnikov, Anton, Zeriouh, Mohamed, Popov, Aron-Frederik ORCID: 0000-0003-4226-3004, Ruhparwar, Arjang, Karck, Matthias and Weymann, Alexander (2017). Cardiac Surgery in Patients With Previous Hepatic or Renal Transplantation: A Pair-Matched Study. Ann. Thorac. Surg., 103 (5). S. 1467 - 1475. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1552-6259

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Abstract

Background. The objective of this study was to compare outcomes of patients with previous solid organ transplant with those of a pair-matched population. Methods. Data from our prospectively maintained cardiac surgery registry were obtained and identified 70 transplant recipients (21 hepatic, 49 renal) who were operated on at our department of cardiac surgery between 2000 and 2013; they formed the transplant group. Those patients were pair-matched regarding age, sex, and cardinal cardiac risk factors to form the pair-matched group. Results. Early mortality was 15.7% in the transplant group (23.8% hepatic, 12.2% renal allograft recipients) versus 5.7% in the pair-matched population. The overall mortality was 32.9% in the transplant group (38.1% hepatic, 30.6% renal allograft recipients) versus 11.4% in the pair-matched group (p < 0.01) over a median follow-up of 32 months. Transplant patients had more bleeding complications (12.9%) than the pair-matched patients (1.4%), and more operative reexploration (15.7% versus 2.9%), atrial fibrillation (32.9% versus 10.0%), newonset dialysis (17.1% versus 5.7%), and sepsis (10.0% versus 1.4%). One-, 2-, 5-, and 10-year survival for the transplant group versus the pair-matched group, respectively, was 74%, 71%, 66%, and 56% versus 93%, 91%, 88%, 81%. Multivariate predictors of mortality were solid organ transplant (hazard ratio 3.8, 95% confidence interval: 1.6 to 9.2), intraoperative transfusion (hazard ratio 1, 95% confidence interval: 1.00 to 1.01), and postoperative increase in bilirubin concentration (hazard ratio 1.34, 95% confidence interval: 1.08 to 1.65). Conclusions. Cardiac surgery is feasible for recipients of solid organ transplants with acceptable early morbidity and mortality. (C) 2017 by The Society of Thoracic Surgeons

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Farag, Mina UNSPECIFIED UNSPECIFIED UNSPECIFIED Nikolic, Marina UNSPECIFIED UNSPECIFIED UNSPECIFIED Arif, Rawa UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmack, Bastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Popov, Aron-Frederik UNSPECIFIED orcid.org/0000-0003-4226-3004 UNSPECIFIED Ruhparwar, Arjang UNSPECIFIED UNSPECIFIED UNSPECIFIED Karck, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-231930
DOI:	10.1016/j.athoracsur.2016.08.092
Journal or Publication Title:	Ann. Thorac. Surg.
Volume:	103
Number:	5
Page Range:	S. 1467 - 1475
Date:	2017
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1552-6259
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SOLID-ORGAN TRANSPLANT; LIVER-TRANSPLANTATION; VALVE-REPLACEMENT; RISK-FACTORS; RECIPIENTS; KIDNEY; MORBIDITY; MORTALITY; OUTCOMES; OPERATIONS Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23193