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Heart retransplantation.

M R Johnson1, K D Aaronson, C E Canter

  • 1University of Wisconsin, Madison, WI, USA. mrj@medicine.wisc.edu

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|July 21, 2007
PubMed
Summary
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Heart retransplantation outcomes are often compromised, with early retransplantation or rejection being key risk factors. Indications for retransplantation include chronic graft dysfunction or vasculopathy, while acute rejection cases are generally unsuitable.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Immunology

Background:

  • Heart retransplantation is uncommon, accounting for 3-4% of procedures.
  • Outcomes following heart retransplantation are generally poorer than primary heart transplants.
  • Risk factors for adverse outcomes include early retransplantation (<6 months), acute rejection, and early allograft failure.

Purpose of the Study:

  • To review the outcomes and identify risk factors associated with heart retransplantation.
  • To define appropriate indications for heart retransplantation.
  • To compare outcomes and risk factors in adult versus pediatric heart retransplantation.

Main Methods:

  • Literature review and analysis of existing data on heart retransplantation outcomes.
  • Expert working group opinion and guideline formulation.

Related Experiment Videos

  • Comparison of risk factors and outcomes between primary transplants and retransplants.

    • Main Results:

    • The incidence of rejection and infection is comparable between primary heart transplants and retransplants.
    • Compromised outcomes and risk factors are similar in both adult and pediatric heart retransplantation.
    • Indications for retransplantation include chronic cardiac allograft vasculopathy or graft dysfunction with heart failure; acute rejection with hemodynamic compromise is a contraindication.

    Conclusions:

    • Heart retransplantation is associated with compromised outcomes, influenced by specific risk factors.
    • Clear indications for heart retransplantation exist, primarily for chronic graft issues, while acute rejection cases are generally excluded.
    • Guidelines for primary heart transplant candidacy must be strictly adhered to for retransplantation evaluations.