Results of heart retransplantation: subanalysis of the Spanish Heart Transplant Registry

Heart retransplantation (ReHT) is controversial in the current era. The aim of this study was to describe and analyze the results of ReHT in Spain. We performed a retrospective cohort analysis from the Spanish Heart Transplant Registry from 1984 to 2018. Data were collected on donors, recipients, su...

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Published in:Revista española de cardiología (English ed.) 2022-01, Vol.75 (1), p.60-66
Main Authors: Salterain-González, Nahikari, Rábago Juan-Aracil, Gregorio, Gómez-Bueno, Manuel, Almenar-Bonet, Luis, Crespo-Leiro, María Generosa, Arizón del Prado, José María, García-Cosío, María Dolores, Martínez-Sellés, Manuel, Mirabet-Pérez, Sonia, Sobrino-Márquez, José Manuel, González-Costello, José, Pérez-Villa, Félix, Díaz-Molina, Beatriz, de la Fuente-Galán, Luis, Blasco-Peiró, Teresa, Garrido-Bravo, Iris P., García-Guereta Silva, Luis, Gil-Villanueva, Nuria, Gran, Ferrán, González-Vilchez, Francisco
Format: Article
Language:English
Subjects:
Graft Rejection - epidemiology
Heart retransplantation
Heart transplant
Heart Transplantation
Humans
Middle Aged
Registries
Reoperation
Retrasplante cardiaco
Retrospective Studies
Spain - epidemiology
Supervivencia
Survival
Trasplante cardiaco
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Summary:Heart retransplantation (ReHT) is controversial in the current era. The aim of this study was to describe and analyze the results of ReHT in Spain. We performed a retrospective cohort analysis from the Spanish Heart Transplant Registry from 1984 to 2018. Data were collected on donors, recipients, surgical procedure characteristics, immunosuppression, and survival. The main outcome was posttransplant all-cause mortality or need for ReHT. We studied differences in survival according to indication for ReHT, the time interval between transplants and era of ReHT. A total of 7592 heart transplants (HT) and 173 (2.3%) ReHT were studied (median age, 52.0 and 55.0 years, respectively). Cardiac allograft vasculopathy was the most frequent indication for ReHT (42.2%) and 59 patients (80.8%) received ReHT >5 years after the initial transplant. Acute rejection and primary graft failure decreased as indications over the study period. Renal dysfunction, hypertension, need for mechanical ventilation or intra-aortic balloon pump and longer cold ischemia time were more frequent in ReHT. Median follow-up for ReHT was 5.8 years. ReHT had worse survival than HT (weighted HR, 1.43; 95%CI, 1.17-1.44; P
ISSN:1885-5857
1885-5857
DOI:10.1016/j.rec.2021.06.009