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Updated: Sep 18, 2025
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Published on: July 18, 2014
Amiodarone Association With Severe Primary Graft Dysfunction and Vasoactive Inotropic Score After Heart
Natalie S Dorsey1, Alec E Biscopink1, Brian A Houston2
1Department of Medicine, Medical University of South Carolina, Charleston, SC.
Insights
Pre-transplant amiodarone use did not impact severe primary graft dysfunction (PGD) or vasoactive inotropic scores (VISs) after heart transplantation (HT). This suggests similar hemodynamic outcomes regardless of amiodarone exposure in heart transplant recipients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Pharmacology
Background:
- The effect of amiodarone on primary graft dysfunction (PGD) and vasoactive inotropic scores (VISs) post-heart transplantation (HT) remains under investigation.
- Understanding these associations is crucial for optimizing post-transplant care and outcomes.
Purpose of the Study:
- To evaluate the association between pre-transplant amiodarone use and the incidence of severe PGD.
- To assess the impact of amiodarone on post-transplant VISs in heart transplant recipients.
Main Methods:
- Retrospective analysis of 183 adult patients undergoing isolated heart transplantation between 2018 and 2023.
- Data collected included amiodarone use (duration, dosage, timing) within six months prior to HT.
- Severe PGD was defined by ISHLT criteria; VISs were calculated post-HT according to ISHLT guidelines.
Main Results:
- Amiodarone use was not significantly associated with an increased risk of severe PGD (P=0.67).
- No significant difference was observed in post-transplant VISs between patients exposed to amiodarone and those not exposed (20 vs 16.3; P=0.122).
Conclusions:
- Pre-transplant amiodarone administration does not appear to negatively affect severe PGD or hemodynamic stability post-heart transplantation.
- These findings support comparable hemodynamic profiles in heart transplant recipients irrespective of prior amiodarone exposure.
Background:
The impact of amiodarone on severe primary graft dysfunction (PGD) and vasoactive inotropic scores (VISs) following heart transplantation (HT) is unclear.
Methods And Results:
We investigated these relationships through a retrospective study of 183 consecutive patients >18 years old who underwent isolated HT at our center from 2018-2023. Data for amiodarone use in the 6 months pre-HT were recorded (duration, cumulative dosage, use at HT, last dose pre-HT). Of the 69 patients in the amiodarone cohort, 37 were considered to be taking amiodarone at the time of transplant. The primary endpoint was severe PGD, as defined by the International Society of Heart and Lung Transplantation (ISHLT) criteria. Post-HT VISs were calculated as defined by ISHLT.
Conclusions:
Amiodarone was not associated with severe PGD (P = 0.67), and there was no difference in post-transplant VISs based on amiodarone exposure [20 (19.6) vs 16.3 (13.8); P = 0.122] (Fig. 1). This study supports similar hemodynamic profiles post-HT, regardless of amiodarone use.
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