Document Detail


Analysis of deaths after heart transplantation: the University of Ottawa Heart Institute experience.
MedLine Citation:
PMID:  8241216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study reviews the clinical outcome of the 132 orthotopic heart transplantations performed at our institute from 1984 through 1991 and focuses on the pathology of those patients who died. The study comprised 124 adults (mean age, 45.6 +/- 0.9 years) and eight children. Twenty-six adult and one pediatric deaths occurred. Operative mortality (within 30 days) was 10.6%, with 84.8% of patients surviving to discharge. Actuarial probabilities of survival at 1 and 5 years were 84% +/- 3% and 71% +/- 6%, respectively. Of the 27 deaths, six (22.2%) occurred in the operating room (from hemorrhage, graft failure, and hyperacute rejection); 14 (51.9%) occurred in-hospital after surgery (from sepsis, rejection, cytomegalovirus disease, or myocardial infarct), and seven (25.9%) occurred after discharge (from rejection and/or recurrent coronary artery disease). Two groups of patients were at higher risk: patients in cardiogenic shock requiring pretransplantation mechanical support, with in-hospital mortality of 39.1%; and patients with previous valve replacement who were taking oral anticoagulants, with intraoperative mortality of 50.0%. Pathologic examination revealed occasional instances of unsuspected coronary artery disease in the donor hearts with more than 50% stenoses of the left anterior descending coronary arteries in three of 21 (14.3%) of cases. Complications of the transplantation or related therapeutic procedures were common among those who died. The complications ranged from functionally insignificant anatomic curiosities to life-threatening problems. These complications are tabulated and shown.
Authors:
V M Walley; R G Masters; S A Boone; A L Wolfsohn; R A Davies; P J Hendry; W J Keon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  12     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:    1993 Sep-Oct
Date Detail:
Created Date:  1993-12-23     Completed Date:  1993-12-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  790-801     Citation Subset:  IM    
Affiliation:
Department of Pathology, University of Ottawa, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anastomosis, Surgical / adverse effects,  statistics & numerical data
Assisted Circulation / statistics & numerical data
Cause of Death
Child
Child, Preschool
Female
Forecasting
Heart Diseases / pathology,  physiopathology
Heart Transplantation / adverse effects,  mortality*,  pathology
Heart, Artificial / statistics & numerical data
Hospital Mortality
Humans
Infant
Infant, Newborn
Male
Middle Aged
Ontario / epidemiology
Reoperation
Risk Factors
Survival Rate
Tissue Donors / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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