title: [Analysis of factors that can influence the appearance of acute heart transplant failure].
abstract: 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.
authors.affiliation: Servicios de Cardiología, Hospital Universitario La Fe, Valencia, Sapin. lmartinezd@meditex.es
authors.forename: Luis
authors.initials: L
authors.lastname: Martínez-Dolz
authors.forename: Luis
authors.initials: L
authors.lastname: Almenar
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Arnau
authors.forename: Ana
authors.initials: A
authors.lastname: Osa
authors.forename: Joaquín
authors.initials: J
authors.lastname: Rueda
authors.forename: José L
authors.initials: JL
authors.lastname: Vicente
authors.forename: Francisco
authors.initials: F
authors.lastname: García-Sánchez
authors.forename: Miguel
authors.initials: M
authors.lastname: Palencia
authors.forename: José M
authors.initials: JM
authors.lastname: Caffarena
mesh_terms: 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