Long-term outcomes of patients with primary graft dysfunction after cardiac transplantation

• Published in: European journal of cardio-thoracic surgery 2021-11, Vol.60 (5), p.1178-1183
• Main Authors: Squiers, John J, DiMaio, J Michael, Van Zyl, Johanna, Lima, Brian, Gonzalez-Stawisnksi, Gonzalo, Rafael, Aldo E, Meyer, Dan M, Hall, Shelley A
• Format: Article
• Language: English
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezab177

Abstract   OBJECTIVES The International Society of Heart and Lung Transplantation (ISHLT) criteria for primary graft dysfunction (PGD) after cardiac transplantation have been shown to stratify patient outcomes up to 1 year after transplantation, but scarce data are available regarding outcomes beyond the 1st year. We sought to characterize survival of patients with PGD following cardiac transplantation beyond the 1st year. METHODS A retrospective review of consecutive patients undergoing isolated cardiac transplantation at a single centre between 2012 and 2015 was performed. Patients were diagnosed with none, mild, moderate or severe PGD by the ISHLT criteria. Survival was ascertained from the United Network for Organ Sharing database and chart review. Kaplan–Meier curves were plotted to compare survival. The hazard ratio for mortality associated with PGD severity was estimated using Cox-proportional hazards modelling, with a pre-specified conditional survival analysis at 90 days. RESULTS A total of 257 consecutive patients underwent cardiac transplantation during the study period, of whom 73 (28%) met ISHLT criteria for PGD: 43 (17%) mild, 12 (5%) moderate and 18 (7%) severe. Patients with moderate or severe PGD had decreased survival up to 5 years after transplantation (log-rank P