Epidemiological characteristics of heart transplant recipients in Peru 2010-2020

Authors

DOI:

https://doi.org/10.47487/apcyccv.v2i4.187

Keywords:

Heart transplantation, Heart diseases, Mortality, Survival, Peru

Abstract

Objective. To evaluate the epidemiological, clinical, surgical, pathological characteristics and outcomes in the follow-up of heart transplant recipients at the National Cardiovascular Institute during 2010-2020. Material and methods. A retrospective descriptive study was performed by reviewing the medical records of patients undergoing heart transplantation at a national referral center, describing the clinical, surgical, laboratory, pathology characteristics and survival of patients up to 10 years of follow-up. Results. Eightysix patients were transplanted in 10 years, the median age was 41 years (RIQ 28-56), being predominantly male (66.3%). The three leading causes of indication for heart transplantation were: dilated cardiomyopathy (48.9%), ischemic heart disease (17.4%), and myocarditis (6.9%). Total ischemia time was 160 minutes (RIQ 129.7-233.5). Survival at one, five, and ten years was 84.8%, 73.6%, and 65.7% respectively. The main cause of death was non-cardiac: infectious (39.1%) and of unknown origin (26%). Conclusions. The main etiology of heart failure in heart transplant recipients in Peru in recent years was nonischemic dilated cardiomyopathy. We observed that the survival rate was similar to that of international registries; however, the rate of mortality due to infectious causes and death of unknown origin is high, which poses a challenge in the management of post-transplant patients.

Downloads

Download data is not yet available.

References

Crespo-Leiro MG, Metra M, Lund LH, Milicic D, Costanzo MR, Filippatos G, et al. Advanced heart failure: a position statement of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(11):1505-35. doi: 10.1002/ejhf.1236.

Truby LK, Rogers JG. Advanced Heart Failure. JACC Heart Fail. 2020;8(7):523-36. doi: 10.1016/j.jchf.2020.01.014.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Colvin MM, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA Guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Am Coll Cardiol. 2017;70(6):776-803. doi: 10.1016/j.jacc.2017.04.025.

Gonzáles-Vilchez F, Almenar-Bonet L, Crespo-Leiro M, Gómez-Bueno M, González-Costello J, Pérez-Villa F, et al. Spanish Heart Transplant Registry. 32nd Official Report of the Heart Failure Association of the Spanish Society of Cardiology. Rev Esp Cardiol (Engl Ed). 2021;74(11):962-970. doi: 10.1016/j.rec.2021.08.001.

Kim I, Youn J, Kobashigawa J. The past, present and future of Heart Transplantation. Korean Circ J. 2018;48(7):565-90. doi: 10.4070/kcj.2018.0189.

Stehlik J, Kobashigawa J, Hunt SA, Reichenspurner H, Kirklin JK. Honoring 50 Years of Clinical Heart Transplantation in Circulation. Circulation. 2018;137(1):71-87. doi: 10.1161/circulationaha.117.029753.

Freitas NC, Cherchiglia ML, Simão C, Alvares-Teodoro J, Acurcio FD, Guerra AA. Dezesseis Anos de Transplante Cardíaco em Coorte Aberta no Brasil: Análise de Sobrevivência de Pacientes em Uso de Imunossupressores. Arq Bras Cardiol. 2021;116(4):744-53. doi: 10.36660/abc.20200117.

Khush KK, Hsich E, Potena L, Cherikh WS, Chambers DC, Harhay MO, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-eighth adult heart transplantation report-2021; Focus on recipient characteristics. J Heart Lung Transplant. 2021;40(10):1035-1049. doi: 10.1016/j.healun.2021.07.015.

Peradejordi MA, Favaloro LE, Vigliano C, Ienedo MF, Martínez L, Moscoloni SE, et al. Resultados del trasplante cardiaco según el perfil clínico del receptor: 21 años de experiencia. Rev Argent Cardiol. 2016;84:243-249. doi: 10.7775/rac.es.v84.i3.8150.

Aguilar C, Alarco W, Soplopuco F, Morón J, Lescano M, Morales J, et al. Patología del trasplante cardiaco en el Perú: Experiencia con 61 casos en un centro de referencia nacional. Rev Peru Med Exp Salud Pública. 2018;35(2):241. doi: 10.17843/rpmesp.2018.352.3264.

Nakatami T, Fukushima N, Ono M, Saiki Y, Matsuda H, Nunoda S, et al. The registry report of heart transplantation in Japan (1999-2014). Circulation J. 2016;80(1):44-50. doi: 10.1253/circj.CJ-15-0975.

Lee H, Jeon E, Kang S, Kim J. Initial Report of the Korean Organ Transplant Registry (KOTRY): Heart Transplantation. Korean Circ J. 2017;47(6):868-876. doi: 10.4070/kcj.2016.0403.

Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, et al. Classification of the cardiomyopathies: a position statement from the european society of cardiology working group on myocardial and pericardial diseases. Eur Heart J. 2007;29(2):270-6. doi: 10.1093/eurheartj/ehm342.

Wilhelm M. Long-term outcome following heart transplantation: current perspective. J Thorac Dis. 2015;7(3):549-551. doi: 10.3978/j.issn.2072-1439.2015.01.46.

Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, et al. Incidence of sudden cardiac death after heart transplantation. Eur Heart J. 2020;41(Suppl 2):ehaa946.0726. doi: 10.1093/ehjci/ehaa946.0726.

Balakrishnan K. Heart transplantation in India-are we there yet? Indian J Thorac Cardiovasc Surg. 2020;36(Suppl 2):159-165. doi: 10.1007/s12055-020-00987-0.

Hsich EM, Blackstone EH, Thuita LW, McNamara DM, Rogers JG, Yancy CW, Goldberg LR, Valapour M, Xu G, Ishwaran H. Heart Transplantation. JACC: Heart Failure [Internet]. Julio de 2020;8(7):557-68. Doi: https://doi.org/10.1016/j.jchf.2020.03.014.

Downloads

Published

2021-12-31

Issue

Section

Original articles

Most read articles by the same author(s)