Clinical characteristics and outcomes of patients with adult congenital heart disease listed for heart and heart‒lung transplantation in the Eurotransplant region
BACKGROUND - The therapeutic success in patients with congenital heart disease (CHD) leads to a growing number of adults with CHD (adult CHD [ACHD]) who develop end-stage heart failure. We aimed to determine patient characteristics and outcomes of ACHD listed for heart transplantation. - METHODS - U...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
25 July 2020
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| In: |
The journal of heart and lung transplantation
Year: 2020, Volume: 39, Issue: 11, Pages: 1238-1249 |
| ISSN: | 1557-3117 |
| DOI: | 10.1016/j.healun.2020.07.012 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.healun.2020.07.012 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S1053249820316636 
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| Author Notes: | Peter Moritz Becher, MD, Benedikt Schrage, MD, Jessica Weimann, MSc, Jacqueline Smits, MD, Christina Magnussen, MD, Hermann Reichenspurner, MD, PhD, Alina Goßling, MSc, Inez Rodrigus, MD, Julia Dumfarth, MD, Michel de Pauw, MD, Katrien François, MD, Olivier van Caenegem, MD, Arnaut Ancion, MD, Johan Van Cleemput, MD, Davor Milicic, MD, Ajay Moza, MD, Peter Schenker, MD, Luise Röhrich, MD, Felix Schönrath, MD, Josef Thul, MD, Michael Steinmetz, MD, Bastian Schmack, MD, Arjang Ruhparwar, MD, Gregor Warnecke, MD, Sebastian V. Rojas, MD, Tim Sandhaus, MD, Assad Haneya, MD, Sandra Eifert, MD, Henryk Welp, MD, László Ablonczy, MD, Florian Wagner, MD, Dirk Westermann, MD, Alexander M. Bernhardt, MD, Dorit Knappe, MD, Stefan Blankenberg, MD, Paulus Kirchhof, MD, Elvin Zengin, MD, and Christoph Sinning, MD |
| Summary: | BACKGROUND - The therapeutic success in patients with congenital heart disease (CHD) leads to a growing number of adults with CHD (adult CHD [ACHD]) who develop end-stage heart failure. We aimed to determine patient characteristics and outcomes of ACHD listed for heart transplantation. - METHODS - Using data from all the patients with ACHD in 20 transplant centers in the Eurotransplant region from 1999 to 2015, we analyzed patient characteristics, waiting list, and post-transplantation outcomes. - RESULTS - A total of 204 patients with ACHD were listed during the study period. The median age was 38 years, and 62.3% of the patients were listed in high urgency (HU), and 37.7% of the patients were in transplantable (T)-listing status. A total of 23.5% of the patients died or were delisted owing to clinical worsening, and 75% of the patients underwent transplantation. Median waiting time for patients with HU-listing status was 4.18 months and with T-listing status 9.07 months. There was no difference in crude mortality or delisting between patients who were HU status listed and T status listed (p=0.65). In multivariable regression analysis, markers for respiratory failure (mechanical ventilation, hazard ratio [HR]: 1.41, 95% CI: 1.11-1.81, p=0.006) and arrhythmias (anti-arrhythmic medication, HR: 1.42, 95% CI: 1.01-2.01, p=0.044) were associated with a higher risk of death or delisting. In the overall cohort, post-transplantation mortality was 26.8% after 1 year and 33.4% after 5 years. - CONCLUSIONS - Listed patients are at high risk of death without differences in the urgency of listing. Respiratory failure requiring invasive ventilation and possibly arrhythmias requiring anti-arrhythmic medication indicate worse outcomes on waiting list. |
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| Item Description: | Gesehen am 11.12.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1557-3117 |
| DOI: | 10.1016/j.healun.2020.07.012 |