Early cardiac allograft failure after orthotopic heart transplantation

Paul Hauptman, Sary Aranki, Gilbert H. Mudge, Gregory S. Couper, Evan Loh

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Early cardiac graft failure has been reported to occur in 4-25% of patients undergoing orthotopic heart transplantation. To further elucidate the characteristics and prognosis of patients with graft failure, we retrospectively identified 10 patients from a series of 212 consecutive recipients with catastrophic graft dysfunction in the absence of acute cellular rejection, right ventricular failure secondary to pulmonary hypertension and technical factors. We present a case report and the experience from one transplant center, a review of the literature and possible strategies for the management of early graft failure. Mean onset of graft failure was 6.5 days (range intraoperative to 23 days). Multivariable analysis revealed a longer total ischemic time in patients with early graft dysfunction (200 ± 14 vs. 166 ± 4 min). No episodes of hyperacute rejection were observed. Pathologic changes noted on biopsy or autopsy included ischemia in 9 and vascular rejection in 1. The mortality at 60 days was 50%. Early use of aggressive mechanical and pharmacological support is described and appears to be important for graft salvage.

Original languageEnglish (US)
Pages (from-to)179-186
Number of pages8
JournalAmerican Heart Journal
Volume127
Issue number1
DOIs
StatePublished - Jan 1 1994
Externally publishedYes

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Heart Transplantation
Allografts
Heart Failure
Transplants
Pulmonary Hypertension
Blood Vessels
Autopsy
Ischemia
Pharmacology
Biopsy
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Early cardiac allograft failure after orthotopic heart transplantation. / Hauptman, Paul; Aranki, Sary; Mudge, Gilbert H.; Couper, Gregory S.; Loh, Evan.

In: American Heart Journal, Vol. 127, No. 1, 01.01.1994, p. 179-186.

Research output: Contribution to journalArticle

Hauptman, Paul ; Aranki, Sary ; Mudge, Gilbert H. ; Couper, Gregory S. ; Loh, Evan. / Early cardiac allograft failure after orthotopic heart transplantation. In: American Heart Journal. 1994 ; Vol. 127, No. 1. pp. 179-186.
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