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Related Experiment Videos

Is third-time heart retransplantation justifiable?

J Odim1, A Banerji, S Bahrami

  • 1David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1741, USA. jodim@mednet.ucla.edu

Transplantation Proceedings
|June 27, 2006
PubMed
Summary

Third-time heart transplantation, while high-risk, shows acceptable mortality. Careful patient selection and experienced centers contribute to favorable outcomes for these complex cardiac allograft recipients.

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Area of Science:

  • Cardiology
  • Transplantation Immunology
  • Surgical Outcomes

Background:

  • Repeat heart transplantation typically involves higher risks compared to primary engraftment.
  • Understanding the outcomes of third-time cardiac allografts is crucial for managing complex patient cases.

Purpose of the Study:

  • To test the hypothesis that third-time cardiac allograft transplantation is associated with prohibitive mortality and morbidity.
  • To evaluate the early and late mortality rates in patients undergoing a third heart transplant.

Main Methods:

  • A review of all third-time cardiac retransplants performed at the institution (n=5) and reported to the United Network for Organ Sharing (UNOS) (n=15) from 1987 to 2003.
  • Analysis of preoperative patient conditions, donor factors, and reasons for retransplantation.

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Main Results:

  • No early or in-hospital mortality was observed among the five patients at the institution.
  • One patient died late from transplant coronary artery disease, and another died following a fourth allograft.
  • The primary causes for retransplantation included acute allograft rejection, chronic rejection/cardiac allograft vasculopathy, and primary graft failure.

Conclusions:

  • Third-time heart allograft transplantation is associated with acceptable mortality rates.
  • Outcomes are influenced by factors such as small sample size, patient selection, younger recipient age, and performance at high-volume, experienced centers.