초록접수 현황
| 20F-138 | 구연 발표 |
Surgical outcomes of cardiac re-transplantation
Jung Hyeon Lim¹, Sung-Ho Jung¹, Jae Joong Kim², Ho Jin Kim¹, Tae Jin Yun¹, Jae Won Lee¹
¹Department of Thoracic and Cardiovascular Surgery, Asan Medical Center
²Division of Cardiology, Asan Medical Center
Purpose : Because of donor shortage, the compromised outcome of cardiac re-transplantation makes concern about ethical and practical problems. We analysed retrospective data of characteristics and outcomes of re-transplantation.
Methods : Between November 1992 and July 2020, a total of 780 cases of heart transplantation has been performed. Among these, there were 30 cases of re-transplantations and they were analysed retrospectively. Median follow up duration after re-transplantation was 31.5(interquartile range 12 to 57.5) months.
Results : Mean age at re-transplantation was 41.7±17.1 years. Indications of re-transplantations were cardiac allograft vasculopathy (67%), primary graft dysfunction (27%), acute rejection (3%), and graft failure (3%). Mean interval between primary transplantation and re-transplantation was 7.3±6.3 years. There were 2 cases of concurrent lung and heart transplantation. Early postoperative complications were reoperation for bleeding in 1 patient(3.3%), primary graft dysfunction in 3 patients(10%), infection in 3 patients(10%), and acute kidney injury requiring continuous renal replacement therapy in 8 patients(26.7%). Early mortality rate was 6.7(2/30)%. Cause of death were sepsis. There was no late mortality. Both 1-year and 5-year survival rate were 93.3±4.6%.
Conclusion : The presents study shows that the early and long term outcomes of re-transplantation were comparable to primary transplantation. Therefore, if candidates are appropriate, cardiac re-transplantation could be acceptable treatment option for failing cardiac allograft patients
Methods : Between November 1992 and July 2020, a total of 780 cases of heart transplantation has been performed. Among these, there were 30 cases of re-transplantations and they were analysed retrospectively. Median follow up duration after re-transplantation was 31.5(interquartile range 12 to 57.5) months.
Results : Mean age at re-transplantation was 41.7±17.1 years. Indications of re-transplantations were cardiac allograft vasculopathy (67%), primary graft dysfunction (27%), acute rejection (3%), and graft failure (3%). Mean interval between primary transplantation and re-transplantation was 7.3±6.3 years. There were 2 cases of concurrent lung and heart transplantation. Early postoperative complications were reoperation for bleeding in 1 patient(3.3%), primary graft dysfunction in 3 patients(10%), infection in 3 patients(10%), and acute kidney injury requiring continuous renal replacement therapy in 8 patients(26.7%). Early mortality rate was 6.7(2/30)%. Cause of death were sepsis. There was no late mortality. Both 1-year and 5-year survival rate were 93.3±4.6%.
Conclusion : The presents study shows that the early and long term outcomes of re-transplantation were comparable to primary transplantation. Therefore, if candidates are appropriate, cardiac re-transplantation could be acceptable treatment option for failing cardiac allograft patients
책임저자: Sung-Ho Jung
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea.
발표자: Jung Hyeon Lim, E-mail : hwoarang_10@naver.com