Effect of therapeutic modification on outcomes in heart transplantation over the past two decades ― a single-center experience in Japan ―

Masanobu Yanase, Keiichiro Iwasaki, Takuya Watanabe, Osamu Seguchi, Seiko Nakajima, Kensuke Kuroda, Hiroki Mochizuki, Sachi Matsuda, Hiromi Takenaka, Megumi Ikura, Naoki Tadokoro, Satsuki Fukushima, Tomoyuki Fujita, Hatsue Ishibashi-Ueda, Takeshi Nakatani, Soichiro Kitamura, Junjiro Kobayashi, Kenichi Tsujita, Hisao Ogawa, Norihide Fukushima

研究成果: ジャーナルへの寄稿学術論文査読

抄録

Background: During these 2 decades (1999-2019), many therapeutic strategies have been developed in the field of heart transplant (HTx) to improve post-HTx outcomes. In the present study, 116 consecutive HTx adults between 1999 and 2019 were retrospectively reviewed to evaluate the influences of a therapeutic modification on post HTx outcomes. Methods and Results: Patient survival, functional status and hemodynamics after HTx and modification of therapeutic strategies were reviewed. The overall cumulative survival rate at 10 and 20 years post-HTx was 96.4 and 76.7%, respectively. There were no significant differences in survival rate or exercise tolerance after HTx between extracorporeal and implantable continuous flow-LVAD. Post-HTx patient survival in patients, irrespective of the donor risk factors such as donor age, low LVEF, history of cardiac arrest, was equivalent across cohorts, while longer TIT and higher inotrope dosage prior to procurement surgery were significant risk factors for survival. In 21 patients given everolimus (EVL) due to renal dysfunction, serum creatinine significantly decreased 1 year after initiation. In 22 patients given EVL due to transplant coronary vasculopathy (TCAV), maximum intimal thickness significantly decreased 3 years after initiation. Conclusions: The analysis of a 20-year single-center experience with HTx in Japan shows encouraging improved results when several therapeutic modifications were made; for example, proactive use of donor hearts declined by other centers and the use of EVL in patients with renal dysfunction and TCAV.

本文言語英語
ページ(範囲)965-974
ページ数10
ジャーナルCirculation Journal
84
6
DOI
出版ステータス出版済み - 2020
外部発表はい

All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

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