%0 Journal Article
%T Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure
%A Pavan Atluri
%A William Hiesinger
%A Robert C Gorman
%A Alberto Pochettino
%A Mariell Jessup
%A Michael A Acker
%A Rohinton J Morris
%A Y Joseph Woo
%J Journal of Cardiothoracic Surgery
%D 2008
%I BioMed Central
%R 10.1186/1749-8090-3-26
%X 709 heart transplants were performed over a 20 year period at our institution. Repeat cardiac transplantation was performed in 15 patients (2.1%). A retrospective analysis was performed to determine the efficacy of cardiac retransplantation. Variables investigated included: 1 yr and 5 yr survival, length of hospitalization, post-operative complications, allograft failure, recipient and donor demographics, renal function, allograft ischemic time, UNOS listing status, blood group, allograft rejection, and hemodynamic function.Etiology of primary graft failure included transplant arteriopathy (n = 10), acute rejection (n = 3), hyperacute rejection (n = 1), and a post-transplant diagnosis of metastatic melanoma in the donor (n = 1). Mean age at retransplantation was 45.5 ¡À 9.7 years. 1 and 5 year survival for retransplantation were 86.6% and 71.4% respectively, as compared to 90.9% and 79.1% for primary transplantation. Mean ejection fraction was 67.3 ¡À 12.2% at a mean follow-up of 32.6 ¡À 18.5 mos post-retransplant; follow-up biopsy demonstrated either ISHLT grade 1A or 0 rejection (77.5 ¡À 95.7 mos post-transplant).Cardiac retransplantation is an efficacious treatment strategy for cardiac allograft failure.The International Society for Heart Lung Transplantation (ISHLT) estimates that over 65,000 heart transplants have been performed worldwide. With the increasing population of heart transplant patients there is an associated large population of patients suffering from allograft failure resulting from 3 major categories: acute rejection, primary graft failure, and transplant arteriopathy. Several clinical and experimental strategies to treat graft failure have been proposed, but these options have not yet proven to be long-term clinical solutions. Cardiac retransplantation remains the only viable long-term treatment for end-stage cardiac allograft failure.A few studies have evaluated outcomes following cardiac retransplantation and have demonstrated good results [1-4].
%U http://www.cardiothoracicsurgery.org/content/3/1/26