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Published on: August 2, 2024
Heart transplant recipient 1-year outcomes during the COVID-19 pandemic
Gabriel Esmailian1,2, Nikhil Patel2, Jignesh K Patel2
1The George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Insights
Heart transplantation remains safe and effective despite COVID-19 changes. Patients transplanted during the pandemic showed similar 1-year outcomes, with a notable increase in freedom from major adverse cardiac events.
Area of Science:
- Cardiology
- Transplantation Medicine
- Infectious Diseases
Background:
- The COVID-19 pandemic presented significant challenges to heart transplantation.
- Immunocompromised heart transplant recipients require careful management to prevent viral spread.
Purpose of the Study:
- To evaluate the impact of modified post-transplant outpatient management on 1-year patient outcomes.
- To compare outcomes of heart transplant recipients during the pandemic with historical controls.
Main Methods:
- Retrospective analysis of 50 heart transplant patients transplanted between March-September 2020.
- Comparison with 482 heart transplant patients from the same period in 2011-2019.
- Assessment of 1-year survival, cardiac allograft vasculopathy, rejection rates, major adverse cardiac events, and length of stay.
Main Results:
- Patients transplanted during the pandemic had comparable 1-year survival and rejection rates to historical controls.
- A significantly higher 1-year freedom from nonfatal major adverse cardiac events (NF-MACE) was observed in the pandemic cohort.
- Hospital and ICU lengths of stay were similar between the groups.
Conclusions:
- Modified outpatient management during the COVID-19 pandemic did not negatively impact 1-year heart transplant outcomes.
- Heart transplantation remains a safe and effective procedure, even with necessary protocol adjustments.
- The observed improvement in freedom from NF-MACE warrants further investigation.
Abstract:
The COVID-19 pandemic initially brought forth considerable challenges to the field of heart transplantation. To prevent the spread of the virus and protect immunocompromised recipients, our center made the following modifications to post-transplant outpatient management: eliminating early coronary angiograms, video visits for postoperative months 7, 9, and 11, and home blood draws for immunosuppression adjustments. To assess if these changes have impacted patient outcomes, the current study examines 1-year outcomes for patients transplanted during the pandemic. Between March and September 2020, we assessed 50 heart transplant patients transplanted during the pandemic. These patients were compared to patients who were transplanted during the same months between 2011 and 2019 (n = 482). Endpoints included subsequent 1-year survival, freedom from cardiac allograft vasculopathy, any-treated rejection, acute cellular rejection, antibody-mediated rejection, nonfatal major adverse cardiac events (NF-MACE), and hospital and ICU length of stay. Patients transplanted during the pandemic had similar 1-year endpoints compared to those of patients transplanted from years prior apart from 1-year freedom from NF-MACE which was significantly higher for patients transplanted during the pandemic. Despite necessary changes being made to outpatient management of heart transplant recipients, heart transplantation continues to be safe and effective with similar 1-year outcomes to years prior.
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