Portal de investigación
Cold ischemia >4 hours increases heart transplantation mortality. An analysis of the Spanish heart transplantation registry
Fecha de publicación:
Fecha Ahead of Print:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Valero-Masa, MJ
- Gonzalez-Vilchez, F
- Crespo-Leiro, MG
- Manito-Lorite, N
- Sobrino-Marquez, JM
- Gomez-Bueno, M
- Delgado-Jimenez, JF
- Perez-Villa, F
- Loidi, VB
- Arizon-el Prado, JM
- Molina, BD
- de la Fuente-Galan, L
- Ocampo, AP
- Bravo, IPG
- Aracil, GRJ
- Martinez-Selles, M
Grupos
Abstract
Background: Cold ischemia time (CIT) has been associated to heart transplantation (HT) prognosis. However, there is still uncertainty regarding the CIT cutoff value that might have relevant clinical implications. Methods: We analyzed all adults that received a first HT during the period 2008-2018. CIT was defined as the time between the cross-clamp of the donor aorta and the reperfusion of the heart. Primary outcome was 1-month mortality. Results: We included 2629 patients, mean age was 53.3 +/- 12.1 years and 655 (24.9%) were female. Mean CIT was 202 +/- 67 min (minimum 20 min, maximum 600 min). One-month mortality per CIT quartile was 9, 12, 13, and 19%. One-year mortality per CIT quartile was 16, 19, 21, and 28%. CIT was an independent predictor of 1-month mortality, but only in the last quartile of CIT >246 min (odds ratio 2.1, 95% confidence interval 1.49-3.08, p < .001). We found no relevant differences in CIT during the study period. However, the impact of CIT in 1-month and 1-year mortality decreased with time (p value for the distribution of ischemic time by year 0.01), particularly during the last 5 years. Conclusions: Although the impact of CIT in HT prognosis seems to be decreasing in the last years, CIT in the last quartile (>246 min) is associated with 1-month and 1-year mortality. Our findings suggest the need to limit HT with CIT > 246 min or to use different myocardial preservation systems if the expected CIT is >4 h. (C) 2020 Elsevier B.V. All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 0167-5273, 1874-1754
- Tipo:
- Article
- Páginas:
- 14-19
- PubMed:
- 32569699
- Enlace a otro recurso:
- www.scopus.com
- Factor de Impacto:
- 1,406 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
International Journal of Cardiology ELSEVIER IRELAND LTD
Citas Recibidas en Web of Science: 35
Documentos
- No hay documentos
Filiaciones
Keywords
- Heart transplant; Ischemic time; Donor selection
Campos de Estudio
Cita
Valero MJ,Gonzalez F,ALMENAR L,Crespo MG,Manito N,Sobrino JM,Gomez M,Delgado JF,Perez F,Loidi VB,Arizon JM,Molina BD,de la Fuente L,Ocampo AP,Bravo I,Aracil GRJ,Martinez M. Cold ischemia >4 hours increases heart transplantation mortality. An analysis of the Spanish heart transplantation registry. Int. J. Cardiol. 2020. 319. p. 14-19. IF:4,164. (2).