Faculty Collaboration Database

Cardiac Surgery Outcomes in Abdominal Solid Organ Transplant Recipients. Ann Thorac Surg 2018 Mar;105(3):757-762

Date

11/28/2017

Pubmed ID

29174777

DOI

10.1016/j.athoracsur.2017.09.002

Scopus ID

2-s2.0-85034861589 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution.

METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant. They were matched for type and year of cardiac surgery, age, sex, body mass index, history of diabetes mellitus, and creatinine level before cardiac surgery.

RESULTS: Median time from abdominal transplant to cardiac surgery was 7 years (interquartile range, 3 to 12 years). Perioperative variables, including surgery and cardiopulmonary bypass time, aortic cross-clamp and intubation time, and intensive care unit stay did not differ between the groups. Hospital length of stay and rate of 30-day hospital readmissions did not differ between the groups. Patients with abdominal transplants had more strokes (4% versus 0.6%; p = 0.005) within 30 days after surgery. There were no differences in renal failure, bleeding, site infections, atrial fibrillation, and pneumonia between the groups. Five patients (4%) died within 30 days after surgery in the abdominal transplant group (4 kidneys, 1 liver, 0 kidney-pancreas), and 7 patients (2%) died in the nontransplanted group (p = 0.24).

CONCLUSIONS: Previous history of abdominal transplant is associated with an increased 30-day incidence of stroke after cardiac surgery. Abdominal transplant does not affect 30-day mortality after cardiac surgery, whereas long-term survival is significantly reduced. Regular patient follow-up and prevention and early treatment of postoperative complications are key to patient survival.

Author List

Kohmoto T, Osaki S, Kaufman DB, Leverson G, DeOliveira N, Akhter SA, Ulschmid S, Lozonschi L, Lushaj EB

Author

Takushi Kohmoto MD, PhD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Cardiac Surgical Procedures
Cardiovascular Diseases
Female
Humans
Length of Stay
Male
Middle Aged
Organ Transplantation
Postoperative Complications
Propensity Score
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome