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A Modified Murine Heterotopic Heart Transplant Protocol Matching Contemporary Standards of Aseptic Technique, Anesthesia, and Analgesia
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Recent Trends of Infectious Complications Following Heart Transplantation
Ashrit Multani1,2, Yasbanoo Moayedi3,4, Alfredo Puing1
1Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
Transplantation
|May 16, 2020
Summary
Advances in immunosuppression and prophylaxis have reduced infectious episodes (IEps) after heart transplantation. Bacterial infections remain most common, but viral and fungal IEps have decreased significantly, improving patient outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Transplantation Medicine
Background:
- Heart transplantation outcomes have improved due to better immunosuppression and infection prevention.
- Infectious episodes (IEps) remain a significant concern for heart transplant recipients.
- This study systematically evaluates IEps in the modern era of heart transplantation.
Purpose of the Study:
- To systematically evaluate the incidence and types of infectious episodes (IEps) after heart transplantation.
- To compare current IEp patterns with historical data from the same center.
- To assess the impact of IEps on patient survival post-heart transplantation.
Main Methods:
- Single-center retrospective review of 279 adult heart transplant recipients (January 2008 - September 2017).
- Collection of baseline demographic, clinical, serological, and outcomes data.
- Kaplan-Meier analysis to assess survival stratified by early IEp occurrence.
Main Results:
- A total of 600 IEps occurred in 279 patients over a median 3-year follow-up.
- Bacterial infections were most common (62.5%), followed by viral (30.0%), fungal (6.7%), and parasitic (0.8%).
- Significant reductions in viral, fungal, and Nocardia infections were observed compared to prior studies.
Conclusions:
- Advancements in immunosuppression and preventive strategies have led to a significant reduction in certain IEps after heart transplantation.
- Prophylactic measures, including pretransplant screening and antimicrobial prophylaxis, are likely contributing factors.
- Ongoing monitoring and management of IEps remain crucial for optimizing long-term outcomes in heart transplant recipients.
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