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Impact of Reported Donor Ejection Fraction on Outcome after Heart Transplantation
The Thoracic and Cardiovascular Surgeon ( IF 1.5 ) Pub Date : 2021-04-16 , DOI: 10.1055/s-0041-1725179
Yukiharu Sugimura 1 , Moritz Benjamin Immohr 1 , Hug Aubin 1 , Arash Mehdiani 1 , Philipp Rellecke 1 , Igor Tudorache 1 , Artur Lichtenberg 1 , Udo Boeken 1 , Payam Akhyari 1
Affiliation  

Objectives The global shortage of donor organs has urged transplanting units to extend donor selection criteria, for example, impaired left ventricular function (LVF), leading to the use of marginal donor hearts. We retrospectively analyzed our patients after orthotopic heart transplantation (oHTX) with a focus on the clinical outcome depending on donor LVF. Methods Donor reports, intraoperative, echocardiographic, and clinical follow-up data of patients undergoing oHTX at a single-center between September 2010 and June 2020 were retrospectively analyzed. Recipients were divided into two groups based on donor left ventricular ejection fraction (dLVEF): impaired dLVEF (group I; dLVEF ≤ 50%; n = 23) and normal dLVEF group (group N; dLVEF > 50%; n = 137). Results There was no difference in 30-day, 90-day, and 1-year survival. However, the duration of in-hospital stay was statistically longer in group I than in group N (N: 40.9 ± 28.3 days vs. I: 55.9 ± 39.4 days, p < 0.05). Furthermore, postoperative infection events were significantly more frequent in group I (p = 0.03), which was also supported by multivariate analysis (p = 0.03; odds ratio: 2.96; confidence interval: 1.12–7.83). Upon correlation analysis, dLVEF and recipient LVEF prove as statistically independent (r = 0.12, p = 0.17). Conclusions Impaired dLVEF is associated with prolonged posttransplant recovery and slightly increased morbidity but has no significant impact on survival up to 1 year posttransplant.

中文翻译:

报告的供体射血分数对心脏移植后结果的影响

目标 供体器官的全球短缺促使移植单位扩大供体选择标准,例如,左心室功能受损 (LVF),导致使用边缘供体心脏。我们回顾性分析了原位心脏移植 (oHTX) 后的患者,重点关注取决于供体 LVF 的临床结果。方法回顾性分析2010年9月至2020年6月在单中心接受oHTX的患者的供者报告、术中、超声心动图和临床随访数据。受者根据供体左心室射血分数 (dLVEF) 分为两组:受损 dLVEF(I 组;dLVEF ≤ 50%;n = 23)和正常 dLVEF 组(N 组;dLVEF > 50%;n = 137)。结果 30 天、90 天和 1 年生存率无差异。然而,在统计学上,I 组的住院时间比 N 组长(N:40.9 ± 28.3 天 vs. I:55.9 ± 39.4 天,p < 0.05)。此外,I 组的术后感染事件明显更频繁(p = 0.03),这也得到多变量分析的支持(p = 0.03;优势比:2.96;置信区间:1.12-7.83)。根据相关性分析,dLVEF 和受者 LVEF 证明在统计上是独立的(r = 0.12,p = 0.17)。结论 dLVEF 受损与移植后恢复时间延长和发病率略有增加有关,但对移植后 1 年的存活率没有显着影响。I组术后感染事件明显更频繁(p = 0.03),这也得到多变量分析的支持(p = 0.03;优势比:2.96;置信区间:1.12-7.83)。根据相关性分析,dLVEF 和受者 LVEF 证明在统计上是独立的(r = 0.12,p = 0.17)。结论 dLVEF 受损与移植后恢复时间延长和发病率略有增加有关,但对移植后 1 年的存活率没有显着影响。I组术后感染事件明显更频繁(p = 0.03),这也得到多变量分析的支持(p = 0.03;优势比:2.96;置信区间:1.12-7.83)。根据相关性分析,dLVEF 和受者 LVEF 证明在统计上是独立的(r = 0.12,p = 0.17)。结论 dLVEF 受损与移植后恢复时间延长和发病率略有增加有关,但对移植后 1 年的存活率没有显着影响。
更新日期:2021-04-18
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