(16%), un combinado de enfermedad vascular del injerto y muerte súbita (14%), tumores (12%) y rec... more (16%), un combinado de enfermedad vascular del injerto y muerte súbita (14%), tumores (12%) y rechazo agudo (8%). Conclusiones. La supervivencia obtenida en España con el trasplante cardiaco, sobre todo en los últimos años, lo sitúa como el tratamiento de elección para cardiopatías irreversibles en situación funcional avanzada y sin otras opciones médicas o quirúrgicas establecidas.
Congenital heart diseases (CHDs) have high infant mortality in their severe forms. When adulthood... more Congenital heart diseases (CHDs) have high infant mortality in their severe forms. When adulthood is reached, a heart transplant (HTx) may be required. Spanish adult population transplanted for CHD was analyzed and compared with the most frequent causes of HTx and between different subgroups of CHD. A total of 6048 patients (HTx 1984-2009) were included. Pediatric transplants (<15 yr), combined transplants, reHTx, and HTx for heart diseases other than idiopathic dilated cardiomyopathy (IDCM) and ischemic heart disease (IHD) were excluded. Total patients included: 3166 (IHD = 1888; IDCM = 1223; CHD = 55). Subgroups were studied as follows: (1) single ventricle with pulmonary stenosis (n = 18), (2) single ventricle with tricuspid atresia and Glenn/Fontan surgery (n = 10), (3) congenitally corrected transposition of the great vessels (TGV) or with switch atrial surgery (n = 10), and (4) CHD with right ventricle overload (n = 17). Survival probability was different between groups (p = 0.0001). Post hoc analysis showed some differences between groups (CHD vs. IHD, p = 0.05; CHD vs. IDCM, p = 0.5; IHD vs. IDCM, p = 0.0001). Early mortality was different between CHD subgroups (group 1 = 19%, group 2 = 40%, group 3 = 0%, group 4 = 29%; p < 0.001); however, overall mortality did not show differences between subgroups (p = 0.5). The percentage of Spanish adult HTx patients for CHD is low (1%). The survival curve is better than for other HTx causes (IHD). Nevertheless, early mortality was higher, particularly in some subgroups (Fontan).
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, Jan 27, 2015
Neoplasm history increases morbidity and mortality after solid-organ transplantation and has disq... more Neoplasm history increases morbidity and mortality after solid-organ transplantation and has disqualified patients from transplantation. Studies are needed to identify factors to be considered when deciding on the suitability of a patient with previous tumor for heart transplantation. A retrospective epidemiological study was conducted in heart transplant (HT) recipients (Spanish Post-Heart-Transplant Tumor Registry) comparing the epidemiologic data, immunosuppressive treatments and incidence of post-HT tumors between patients with previous malignant non-cardiac tumors (PT) and with no previous tumors (NPT). The impact of PT on overall survival (OS) was also assessed. 4,561 patients, 77 PT and 4,484 NPT, were evaluated. The NPT group had a higher proportion of men than the PT group (p<0.001). The incidence of post-HT tumors was 1.8 times greater in the PT group (95% CI=1.2-2.6; p<0.001), mainly due to the increased risk in patients with a previous hematologic tumor (RR=2.3; 95...
El shock cardiogénico es una complicación que conlleva una mortalidad muy alta 1 . En la mayoría ... more El shock cardiogénico es una complicación que conlleva una mortalidad muy alta 1 . En la mayoría de las series publicadas, la incidencia de fallo cardiaco poscardiotomía es del 0,2-1,2% 2 . Cuando todas las opciones terapéuticas han sido ineficaces, el trasplante cardiaco puede ser la única alternativa 3 . Hasta la llegada de un donante es preciso mantener la estabilidad hemodinámica con algún dispositivo mecánico.
(16%), un combinado de enfermedad vascular del injerto y muerte súbita (14%), tumores (12%) y rec... more (16%), un combinado de enfermedad vascular del injerto y muerte súbita (14%), tumores (12%) y rechazo agudo (8%). Conclusiones. La supervivencia obtenida en España con el trasplante cardiaco, sobre todo en los últimos años, lo sitúa como el tratamiento de elección para cardiopatías irreversibles en situación funcional avanzada y sin otras opciones médicas o quirúrgicas establecidas.
Congenital heart diseases (CHDs) have high infant mortality in their severe forms. When adulthood... more Congenital heart diseases (CHDs) have high infant mortality in their severe forms. When adulthood is reached, a heart transplant (HTx) may be required. Spanish adult population transplanted for CHD was analyzed and compared with the most frequent causes of HTx and between different subgroups of CHD. A total of 6048 patients (HTx 1984-2009) were included. Pediatric transplants (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;15 yr), combined transplants, reHTx, and HTx for heart diseases other than idiopathic dilated cardiomyopathy (IDCM) and ischemic heart disease (IHD) were excluded. Total patients included: 3166 (IHD = 1888; IDCM = 1223; CHD = 55). Subgroups were studied as follows: (1) single ventricle with pulmonary stenosis (n = 18), (2) single ventricle with tricuspid atresia and Glenn/Fontan surgery (n = 10), (3) congenitally corrected transposition of the great vessels (TGV) or with switch atrial surgery (n = 10), and (4) CHD with right ventricle overload (n = 17). Survival probability was different between groups (p = 0.0001). Post hoc analysis showed some differences between groups (CHD vs. IHD, p = 0.05; CHD vs. IDCM, p = 0.5; IHD vs. IDCM, p = 0.0001). Early mortality was different between CHD subgroups (group 1 = 19%, group 2 = 40%, group 3 = 0%, group 4 = 29%; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001); however, overall mortality did not show differences between subgroups (p = 0.5). The percentage of Spanish adult HTx patients for CHD is low (1%). The survival curve is better than for other HTx causes (IHD). Nevertheless, early mortality was higher, particularly in some subgroups (Fontan).
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, Jan 27, 2015
Neoplasm history increases morbidity and mortality after solid-organ transplantation and has disq... more Neoplasm history increases morbidity and mortality after solid-organ transplantation and has disqualified patients from transplantation. Studies are needed to identify factors to be considered when deciding on the suitability of a patient with previous tumor for heart transplantation. A retrospective epidemiological study was conducted in heart transplant (HT) recipients (Spanish Post-Heart-Transplant Tumor Registry) comparing the epidemiologic data, immunosuppressive treatments and incidence of post-HT tumors between patients with previous malignant non-cardiac tumors (PT) and with no previous tumors (NPT). The impact of PT on overall survival (OS) was also assessed. 4,561 patients, 77 PT and 4,484 NPT, were evaluated. The NPT group had a higher proportion of men than the PT group (p<0.001). The incidence of post-HT tumors was 1.8 times greater in the PT group (95% CI=1.2-2.6; p<0.001), mainly due to the increased risk in patients with a previous hematologic tumor (RR=2.3; 95...
El shock cardiogénico es una complicación que conlleva una mortalidad muy alta 1 . En la mayoría ... more El shock cardiogénico es una complicación que conlleva una mortalidad muy alta 1 . En la mayoría de las series publicadas, la incidencia de fallo cardiaco poscardiotomía es del 0,2-1,2% 2 . Cuando todas las opciones terapéuticas han sido ineficaces, el trasplante cardiaco puede ser la única alternativa 3 . Hasta la llegada de un donante es preciso mantener la estabilidad hemodinámica con algún dispositivo mecánico.
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