Clinical Factors Implicated in Primary Graft Dysfunction After Heart Transplantation: A Single-center Experience

Area of Science:

• Cardiology
• Transplantation Immunology
• Surgical Outcomes

Background:

• Primary graft dysfunction (PGD) is a significant complication following cardiac transplantation.
• PGD is a leading cause of mortality in heart transplant recipients.
• Identifying factors associated with PGD is crucial for developing preventive strategies.

Purpose of the Study:

• To identify donor and surgical factors associated with PGD after cardiac transplantation.
• To guide strategies for PGD prevention.

Main Methods:

• Retrospective analysis of medical records of cardiac transplant recipients.
• Study period: October 2012 to February 2015.
• Inclusion of 99 patients, with 18 developing PGD.

Main Results:

• Univariate analysis identified donor opioid use and death due to anoxia as associated with PGD.
• Recipient/donor blood type AB/A match and longer time from brain death to aortic cross-clamp (TBDACC) ≥3 and ≥5 days were associated with PGD.
• Multivariate analysis confirmed that longer TBDACC (≥3 and ≥5 days) was associated with significantly lower odds of developing PGD (OR 0.098 and 0.092, respectively).

Conclusions:

• A longer TBDACC is associated with a reduced likelihood of PGD.
• Postponing heart procurement for a few days after brain death may be beneficial in preventing PGD.