Do Prior Driveline Infections Increase the Risk of Infection in Heart Transplant Patients Treated With Rabbit...

Area of Science:

• Cardiology
• Transplantation immunology
• Infectious disease

Background:

• Mechanical circulatory support devices (MCSDs) are increasingly used, with driveline infections (DLIs) affecting up to 50% of patients.
• Circulating antibodies in MCSD patients are linked to poor heart transplant outcomes.
• Rabbit antithymocyte globulin (ATG) induction therapy is used to reduce antibodies in heart transplant recipients.

Purpose of the Study:

• To determine if ATG induction therapy increases infection risk in MCSD patients with prior DLIs undergoing heart transplantation.

Main Methods:

• A cohort of 57 MCSD patients receiving heart transplants and ATG induction was analyzed.
• Patients were stratified into those with and without previous DLIs.
• Outcomes assessed included 1-year freedom from infection (sternal wound infections), survival, and freedom from rejection.

Main Results:

• MCSD patients with prior DLIs receiving ATG induction showed no lower freedom from post-transplant infections, including sternal wound infections, compared to those without DLIs.
• No significant differences in 1-year survival or freedom from treated rejection were observed between the groups.

Conclusions:

• ATG induction therapy does not appear to elevate the risk of post-transplant infection in heart transplant recipients with a history of MCSD DLIs.
• ATG induction can be safely administered to MCSD patients with prior DLIs undergoing heart transplantation.