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Factors Related to the Acute Cellular Rejection During the First Year After Heart Transplant

E Toro-Trujillo1, E Garcia1, A A Garcia-Peña2

  • 1Department of Internal Medicine, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.

Transplantation Proceedings
|December 23, 2018
PubMed

Insights

Acute cellular rejection after heart transplant is linked to cyclosporine levels outside the therapeutic range and recipient age. Maintaining optimal immunosuppression and considering patient age are crucial for long-term graft survival.

Area of Science:

  • Cardiology
  • Transplantation immunology
  • Medical statistics

Background:

  • Acute cellular rejection (ACR) significantly impacts long-term heart graft viability.
  • Identifying early predictors of ACR is crucial for improving patient outcomes post-transplant.

Purpose of the Study:

  • To determine factors associated with acute cellular rejection within the first year following heart transplantation.
  • To utilize a longitudinal model with repeated measures for comprehensive analysis.

Main Methods:

  • Retrospective cohort study of heart transplant recipients (2005-2018).
  • Generalized estimating equation approach with an interchangeable correlation structure was employed.
  • Statistical significance was determined using the quasi-likelihood information criterion and P < .05.

Main Results:

  • Fifty-five patients were analyzed; 1-year accumulated mortality was 23.6%.
  • The incidence of acute cellular rejection peaked at 79.9% by the third month, predominantly grade 1.
  • Factors associated with rejection included cyclosporine levels outside the therapeutic range (P < .03) and recipient age (P = .049).

Conclusions:

  • Longitudinal data analysis identified key factors influencing early acute cellular rejection.
  • Therapeutic levels of cyclosporine within the first six months and recipient age are significant predictors of ACR.
  • These findings underscore the importance of monitoring immunosuppression and patient-specific factors in heart transplant recipients.
Abstract

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