Integrating risks and benefits: pretransplant assessment and patient selection for heart transplantation in adult congenital heart disease.

IF 1.8 4区 医学 Q3 TRANSPLANTATION
Matthew J Lewis, Kelly H Schlendorf, Leigh C Reardon
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引用次数: 0

Abstract

Purpose of review: The number of adult congenital heart disease (ACHD) patients presenting for consideration of heart transplantation continues to grow. Comprehensive pretransplant assessment and thoughtful patient selection are of critical importance to mitigate perioperative and posttransplant morbidity and mortality in this population.

Recent findings: There is increasing evidence that patient outcomes after the onset of heart failure in the ACHD population are poor while overall transplant outcomes for ACHD patients have improved over time. Delineation of factors associated with better versus worse posttransplant outcomes is an area of ongoing research. Several studies have found that delayed patient referral, anatomic complexity and the presence of noncardiac organ dysfunction may increase peri-transplant and posttransplant risk.

Summary: Pretransplant assessment and patient selection in ACHD patients should focus on mitigating perioperative and early posttransplant risk. Anatomic complexity, noncardiac organ dysfunction, and referral timing after the onset of heart failure can contribute to poor posttransplant outcomes and should inform patient selection.

整合风险与收益:成人先天性心脏病患者心脏移植前评估与患者选择。
审查目的:考虑进行心脏移植的成人先天性心脏病(ACHD)患者人数持续增长。全面的移植前评估和深思熟虑的患者选择对于降低这一人群的围手术期和移植后发病率及死亡率至关重要:越来越多的证据表明,ACHD 患者在心力衰竭发生后的预后较差,而随着时间的推移,ACHD 患者的总体移植预后有所改善。目前正在研究与移植后预后好坏相关的因素。一些研究发现,患者转诊延迟、解剖结构复杂以及存在非心脏器官功能障碍可能会增加移植围手术期和移植后的风险。摘要:ACHD 患者的移植前评估和患者选择应侧重于降低围手术期和早期移植后的风险。解剖复杂性、非心脏器官功能障碍和心力衰竭发生后的转诊时机可能会导致移植后不良预后,因此在选择患者时应加以考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
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