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Characteristics and Outcomes of Patients Undergoing Combined Organ Transplantation (from the United Network for Organ Sharing).
The American Journal of Cardiology ( IF 2.8 ) Pub Date : 2020-05-24 , DOI: 10.1016/j.amjcard.2020.05.034
Alexandros Briasoulis 1 , Emmanuel Akintoye 1 , Toshiki Kuno 1 , Paulino Alvarez 1
Affiliation  

Studies have shown that highly selected patients who underwent combined heart-kidney (HK) and heart-liver transplants (HLv) have short- and long-term outcomes comparable to those observed in primary heart transplantation (HT). Adults patients with stage D heart failure that underwent combined HK, HLv, and heart-lung (HL) were identified in the United Network for Organ Sharing registry from 1991 to 2016, with follow-up through March 2018. We conducted inverse probability of treatment weighting survival analysis of long-term survival stratified by type of combined organ transplant, accounting for donor, recipient, and operative characteristics. We identified 2,300 patients who underwent combined organ transplant (HK 1,257, HLv 212, HL 831). HL recipients were more likely white (77%), women (58%), with congenital heart disease (44.5%), and longer waiting list time (median 195 days). HK transplant increased significantly during the study period where as HL decreased significantly. Median survival was 12.2 years for HK (95% confidence intervals [CI] 10.8 to 12.8), 12 for HLv (95% CI 8.6 to 17.6) but significantly lower at 4.5 years for HL (95% CI 3.6 to 5.8). Combined HK and HLv transplantation rates are increasing and long-term survival is comparable to primary HT, unlike HL which is associated with decreasing trends and significantly lower survival.



中文翻译:

联合器官移植患者的特征和结果(来自器官共享联合网络)。

研究表明,经过高度选择的接受心脏-肾脏(HK)和心脏-肝移植(HLv)联合治疗的患者的短期和长期结局可与原发心脏移植(HT)的结果相媲美。1991年至2016年在联合器官共享网络登记处确定了合并了HK,HLv和心肺(HL)的成年D期心力衰竭患者,并随访至2018年3月。我们进行了逆向治疗按联合器官移植的类型对长期生存进行加权生存分析,并考虑供体,受体和手术特点。我们确定了2,300例接受了联合器官移植的患者(HK 1,257,HLv 212,HL 831)。HL接受者更可能是白人(77%),女性(58%),先天性心脏病(44.5%),以及更长的等待列表时间(平均195天)。在研究期间HK移植显着增加,而HL显着降低。HK的中位生存期为12.2年(95%置信区间[CI]为10.8至12.8),HLv的中位生存期为12年(95%的CI为8.6至17.6),而HLv的中位生存期仅为4.5年(95%的CI为3.6至5.8)。HK和HLv的联合移植率正在增加,并且长期存活率与原发性HT相当,而HL则与趋势下降和存活率显着降低有关。

更新日期:2020-07-25
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