[Analysis of factors that can influence the appearance of acute heart transplant failure].
OBJECTIVE
Acute graft failure (AGF) is defined as significant failure of myocardial function in a newly implanted heart. The aim of the present study was to investigate a series of factors related to heart transplantation (HT) in relation to AGF.


METHODS
In a study of 287 consecutive HTs performed over a 14-year period, AGF was defined when: a) the surgeon observed ventricular dysfunction before closing the sternotomy; b) various inotropic drugs were required at high doses in the first days after surgery, or c) ventricular dysfunction was identified by routine echocardiography in the immediate postoperative period. Statistical analysis comprised a descriptive and univariate comparative study, followed by multivariate analysis based on application of a logistical regression model.


RESULTS
The incidence of AGF was 22%. Predictors of AGF were female donor status (OR = 2.2; 95% CI, 1.2-4.4; p = 0.02), a disproportion of more than 20% in donor-recipient body weight (OR = 2.2; 95% CI, 1.1-4.3; p = 0.02), and background ischemic heart disease (OR = 2.5; 95% CI, 5.5-1.1; p = 0.03) or valve pathology (OR = 5.0; 95% CI, 7.0-1.5; p = 0.01).


CONCLUSIONS
AGF is a frequent pathology, which was present in 22% of our heart transplantation patients. Among the modifiable factors related to AGF was a clear disproportion in body weight and the size of grafts from female donors. Unmodifiable factors related to AGF were ischemic heart disease and valvular heart disease as a cause of heart transplantation.
Martínez-Dolz
Luis
L
Servicios de Cardiología, Hospital Universitario La Fe, Valencia, Sapin. lmartinezd@meditex.es
Almenar
Luis
L
Arnau
Miguel A
MA
Osa
Ana
A
Rueda
Joaquín
J
Vicente
José L
JL
García-Sánchez
Francisco
F
Palencia
Miguel
M
Caffarena
José M
JM
D000208:Acute Disease; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology*; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors