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Heart transplantation in patients with end-stage heart failure and cardiac ascites

Ron-Bin Hsu1

  • 1Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. ronbin@ntuh.gov.tw

Circulation Journal : Official Journal of the Japanese Circulation Society
|October 30, 2007
PubMed

Insights

Heart transplantation outcomes for patients with heart failure and ascites are poor, with high hospital mortality. Low serum albumin and re-operation for bleeding independently predict death in these complex cases.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Critical Care

Background:

  • Clinical outcomes of heart transplantation in patients with heart failure and ascites remain largely unreported.
  • This study evaluates the clinical outcomes of orthotopic heart transplantation in patients presenting with both heart failure and ascites.

Purpose of the Study:

  • To assess the clinical outcome of heart transplantation in patients with heart failure and ascites.
  • To identify risk factors associated with hospital mortality in this patient population.

Main Methods:

  • Retrospective analysis of 45 patients who underwent orthotopic heart transplantation between 1989 and 2005 for heart failure with ascites.
  • Evaluation of hospital mortality, causes of death, and need for re-operation.
  • Identification of independent risk factors for hospital death using logistic regression.

Main Results:

  • Hospital mortality was 22% (10 of 45 patients), with common causes including sepsis and bleeding.
  • Re-operation for postoperative bleeding was required in 31% of patients (14 of 45).
  • Independent risk factors for hospital death included low serum albumin (OR 0.05) and re-operation for bleeding (OR 30.11).

Conclusions:

  • Heart transplantation in patients with heart failure and ascites is associated with high hospital mortality and morbidity.
  • The presence of ascites and hypoalbuminemia indicates a poor prognosis in patients undergoing heart transplantation.
Abstract

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