青紫型和非青紫型先天性心脏病患者心肺移植对生存的影响。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-01-01 DOI:10.1016/j.transproceed.2024.12.005

Víctor Donoso-Trenado , Raquel López-Vilella , Joaquín Rueda-Soriano , Francisco Buendía-Fuentes , Luis Martínez-Dolz , Luis Almenar-Bonet

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引用次数: 0

摘要

背景：高比例的先天性心脏病（CHD）患者成年后，需要心脏移植（HTx）或联合心肺移植（HLTx）。在冠心病中，有一些亚组与较高的风险相关。方法：回顾性分析冠心病患者HTx和HLTx的变化。它们又被细分为紫绀型或非紫绀型冠心病的病因。对比分析基线特征和死亡率。没有对HTx和HLTx进行比较分析。结果：共行HTx 1015例，其中首次HTx 933例（91.1%），再行HTx 42例（4.1%）。其中18例（1.8%）为冠心病患者。HLTx组有18例（42.8%）患有冠心病。在HTx组中，与矫正手术更为常见的非青紫患者相比，青紫患者的手术干预较少（57%对18%）。紫绀患者死亡率较高（57.1% vs. 18.2%），中位生存期略低（15.9 vs. 16.7年）。在HLTx组中，90%的紫绀患者以前没有做过手术，而在另一组中，这一比例为25%。紫绀型患者的死亡率较高（60% vs. 37.5%），中位生存期较低（1.7 vs. 9.5年）。死亡率主要发生在头30天，紫绀患者死亡率更高。结论：在HTx或HTx后的冠心病患者中，青紫状况与较低的生存率相关，前30天死亡率较高。

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Impact on Survival of Heart and Heart-Lung Transplantation in Patients With Cyanotic and Noncyanotic Congenital Heart Diseases

Background

A high percentage of patients with congenital heart diseases (CHD) reach adulthood and, over time, require heart transplantation (HTx) or combined heart-lung transplantation (HLTx). Among CHD, there are subgroups associated with a higher risk.

Methods

Retrospective analysis of HTx and HLTx in CHD patients. They are subdivided based on the etiology of cyanotic or noncyanotic CHD. Baseline characteristics and mortality are comparatively analyzed. No comparative analysis is performed between HTx and HLTx.

Results

A total of 1015 HTx were performed, 933 (91,9%) were first-time HTx, and 42 (4.1%) were HLTx. Of the HTx, 18 (1.8%) were in CHD patients. In the HLTx group, 18 (42.8%) had CHD. In the HTx group, cyanotic patients had fewer surgical interventions (57% vs. 18%), compared to noncyanotic patients, where corrective surgeries were more common. Cyanotic patients had a higher mortality rate (57.1% vs. 18.2%), and their median survival was slightly lower (15.9 vs. 16.7 years). In the HLTx group, ninety percent of cyanotic patients had no previous surgeries, compared to 25% in the other group. The mortality rate was higher in cyanotic patients (60% vs. 37.5%), and their median survival was lower (1.7 vs. 9.5 years). Mortality occurred mainly in the first 30 days and was higher in cyanotic patients.

Conclusions

In CHD patients following HTx or HLTx, cyanotic conditions are associated with lower survival, with higher mortality occurring during the first 30 days.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.