Higher rate of comorbidities after cardiac retransplantation contributes to decreased survival.
BACKGROUND
Cardiac retransplantation is the definitive treatment for allograft failure despite decreased long-term survival in these patients. The cause of the poorer outcomes in cardiac retransplant patients is unclear.


METHODS
This study was a retrospective analysis of 859 adult cardiac transplant patients. Of these, 45 (5.7%) underwent cardiac retransplantation at 8.2 +/- 5.3 (mean +/- SD) years after the first transplant, primarily for severe transplant vasculopathy (n = 42).


RESULTS
One-year survival for retransplant patients was significantly lower compared with de novo transplant patients (75% vs 87%; p < 0.003). Twenty-three patients died due to either malignancy (n = 8), infection (n = 6), rejection (n = 3), sudden death (n = 2), recurrent transplant coronary artery disease (n = 2) or post-operative bleeding (n = 1).


CONCLUSIONS
Although cardiac retransplantation has immediate life-saving benefits, survival is lower compared with de novo cardiac transplantation due to higher rates of malignancy and infection.
Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Lana
L
Tsao
Nir
N
Uriel
Katherine
K
Leitz
Yoshifuma
Y
Naka
Donna
D
Mancini
D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D016027:Heart Transplantation / Q000276:immunology / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology*; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology*; D017063:Outcome Assessment, Health Care; D019233:Retreatment; D012189:Retrospective Studies; D015996:Survival Rate
D007166:Immunosuppressive Agents