Heart Vessels DOI 10.1007/s00380-015-0649-1
ORIGINAL ARTICLE
Incidence, etiology, and outcome of primary graft dysfunction in adult heart transplant recipients: a single‑center experience in Japan Osamu Seguchi · Tomoyuki Fujita · Yoshihiro Murata · Haruki Sunami · Takuma Sato · Takuya Watanabe · Seiko Nakajima · Kensuke Kuroda · Eriko Hisamatsu · Takamasa Sato · Masanobu Yanase · Hiroki Hata · Kyoichi Wada · Hatsue Ishibashi‑Ueda · Junjiro Kobayashi · Takeshi Nakatani
Received: 25 December 2014 / Accepted: 6 February 2015 © Springer Japan 2015
Abstract Donor and recipient characteristics, as well as donor–recipient matching, affect clinical outcomes after heart transplantation (HTx). This study aimed to clarify how donor and recipient characteristics affect the clinical course after HTx. The medical records of all the patients who underwent HTx at the National Cerebral and Cardiovascular Center from 1999 to 2014 were retrospectively reviewed. Sixty-one patients (48 males) underwent HTx. Six recipients (9.8 %) developed primary graft dysfunction (PGD) determined by criteria recently established at a consensus conference. Development of PGD was associated with high-dose inotropic support for the donor heart and a history of stroke in the recipient (p = 0.04 and p = 0.002, respectively). Recipients with PGD had higher right atrial pressure (RAP) and lower cardiac output (CO) compared with those without PGD at 6 months after HTx (RAP,
O. Seguchi (*) · Y. Murata · H. Sunami · T. Sato · T. Watanabe · S. Nakajima · K. Kuroda · E. Hisamatsu · T. Sato · M. Yanase · T. Nakatani Department of Transplantation, National Cerebral and Cardiovascular Center, 5‑7‑1 Fujishirodai, Suita, Osaka 565‑8565, Japan e-mail: [email protected]; [email protected] T. Fujita · H. Hata · J. Kobayashi Department of Adult Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan K. Wada Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan H. Ishibashi‑Ueda Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
6.8 ± 3.6 vs. 2.8 ± 2.2 mmHg, p 13 mm), (5) history of cardiopulmonary arrest, (6) high doses of inotropes (>10 μg/min/kg) or the use of norepinephrine, (7) reduced cardiac function (LVEF 20 mmHg, or CI 15 mmHg, PCWP > 20 mmHg, CI
ORIGINAL ARTICLE
Incidence, etiology, and outcome of primary graft dysfunction in adult heart transplant recipients: a single‑center experience in Japan Osamu Seguchi · Tomoyuki Fujita · Yoshihiro Murata · Haruki Sunami · Takuma Sato · Takuya Watanabe · Seiko Nakajima · Kensuke Kuroda · Eriko Hisamatsu · Takamasa Sato · Masanobu Yanase · Hiroki Hata · Kyoichi Wada · Hatsue Ishibashi‑Ueda · Junjiro Kobayashi · Takeshi Nakatani
Received: 25 December 2014 / Accepted: 6 February 2015 © Springer Japan 2015
Abstract Donor and recipient characteristics, as well as donor–recipient matching, affect clinical outcomes after heart transplantation (HTx). This study aimed to clarify how donor and recipient characteristics affect the clinical course after HTx. The medical records of all the patients who underwent HTx at the National Cerebral and Cardiovascular Center from 1999 to 2014 were retrospectively reviewed. Sixty-one patients (48 males) underwent HTx. Six recipients (9.8 %) developed primary graft dysfunction (PGD) determined by criteria recently established at a consensus conference. Development of PGD was associated with high-dose inotropic support for the donor heart and a history of stroke in the recipient (p = 0.04 and p = 0.002, respectively). Recipients with PGD had higher right atrial pressure (RAP) and lower cardiac output (CO) compared with those without PGD at 6 months after HTx (RAP,
O. Seguchi (*) · Y. Murata · H. Sunami · T. Sato · T. Watanabe · S. Nakajima · K. Kuroda · E. Hisamatsu · T. Sato · M. Yanase · T. Nakatani Department of Transplantation, National Cerebral and Cardiovascular Center, 5‑7‑1 Fujishirodai, Suita, Osaka 565‑8565, Japan e-mail: [email protected]; [email protected] T. Fujita · H. Hata · J. Kobayashi Department of Adult Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan K. Wada Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan H. Ishibashi‑Ueda Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
6.8 ± 3.6 vs. 2.8 ± 2.2 mmHg, p 13 mm), (5) history of cardiopulmonary arrest, (6) high doses of inotropes (>10 μg/min/kg) or the use of norepinephrine, (7) reduced cardiac function (LVEF 20 mmHg, or CI 15 mmHg, PCWP > 20 mmHg, CI
