| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | The Journal of Heart and Lung Transplantation | ||||
| Verlag: | ELSEVIER SCIENCE INC | ||||
| Ort der Veröffentlichung: | NEW YORK | ||||
| Band: | 42 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 6 | ||||
| Seitenbereich: | S. 778-785 | ||||
| Datum: | 2023 | ||||
| Institutionen: | Medizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie | ||||
| Identifikationsnummer: |
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| Stichwörter / Keywords: | RISK; AL; PATHOPHYSIOLOGY; SURVIVAL; | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 76169 |
Web of ScienceZusammenfassung
BACKGROUND: When advanced heart failure occurs in cardiac amyloidosis, prognosis is poor. In this setting heart transplantation (HTX) is a treatment option for selected patients. We here present the results of post-transplantation outcomes in cardiac amyloidosis within the Eurotransplant area, investi-gating possible predictors of survival.METHODS: Of 115 patients undergoing HTX due to cardiac ...
Zusammenfassung
BACKGROUND: When advanced heart failure occurs in cardiac amyloidosis, prognosis is poor. In this setting heart transplantation (HTX) is a treatment option for selected patients. We here present the results of post-transplantation outcomes in cardiac amyloidosis within the Eurotransplant area, investi-gating possible predictors of survival.METHODS: Of 115 patients undergoing HTX due to cardiac amyloidosis in the Eurotransplant region between November 1987 and May 2020, detailed assessment prior to transplantation was available in 85 patients. The present study was conducted in a retrospective approach. Primary endpoint was mortality after HTX. Baseline variables were entered in a Cox proportional hazards model with the pri-mary endpoint as a dependent variable.RESULTS: Median overall survival following HTX was 6.3 years in the overall collective and the sub-group. Univariate Cox proportional hazards model revealed a significant relationship between overall survival and the transplantation period (2008 to 2020 vs 1987 to 2007; median survival 9.7 years vs 1.8 years, hazard ratio 0.45, p = 0.01). Further predictors were albumin concentration (hazard ratio 0.92, p < 0.001), and systolic blood pressure (hazard ratio 0.96, p < 0.001). The transplant period as well as albumin concentration remained significant independent predictors in the AL sub cohort in a multivariate Cox proportional hazards model.CONCLUSIONS: HTX is a viable treatment option for patients at an advanced stage of cardiac amyloid-osis as overall survival after transplantation has improved in the modern age. Patients at a very advanced stage of the disease, indicated by low serum albumin and blood pressure, show worse out-comes following HTX. Optimal timing and careful patient selection may therefore be particularly important to further improve post-HTX survival in amyloidosis patients.J Heart Lung Transplant 2023;42:778-785 (c) 2023 International Society for Heart and Lung Transplantation. All rights reserved.
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