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.
Tsao
Lana
L
Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Uriel
Nir
N
Leitz
Katherine
K
Naka
Yoshifuma
Y
Mancini
Donna
D
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