title: Incidence, etiology, and outcome of primary graft dysfunction in adult heart transplant recipients: a single-center experience in Japan.
abstract: Donor and recipient characteristics, as well as donor-recipient matching, affect clinical outcomes after heart transplantation (HTx). This study aimed to clarify how donor and recipient characteristics affect the clinical course after HTx. The medical records of all the patients who underwent HTx at the National Cerebral and Cardiovascular Center from 1999 to 2014 were retrospectively reviewed. Sixty-one patients (48 males) underwent HTx. Six recipients (9.8 %) developed primary graft dysfunction (PGD) determined by criteria recently established at a consensus conference. Development of PGD was associated with high-dose inotropic support for the donor heart and a history of stroke in the recipient (p = 0.04 and p = 0.002, respectively). Recipients with PGD had higher right atrial pressure (RAP) and lower cardiac output (CO) compared with those without PGD at 6 months after HTx (RAP, 6.8 ± 3.6 vs. 2.8 ± 2.2 mmHg, p < 0.001; CO, 4.6 ± 0.8 l vs. 5.8 ± 1.2 l/min, p = 0.02). With respect to survival, patients with PGD had a 5-year survival rate equivalent to those without PGD (83.3 vs. 93.3 %, p = 0.23). High-dose inotropic support for the donor heart and a history of stroke in the recipient are significant predictive factors for the development of PGD. However, recipients with PGD demonstrate mid-term survival comparable to those without PGD.
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan. oseguchi@hsp.ncvc.go.jp.
authors: Osamu
authors: O
authors: Seguchi
authors: Department of Adult Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Tomoyuki
authors: T
authors: Fujita
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Yoshihiro
authors: Y
authors: Murata
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Haruki
authors: H
authors: Sunami
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Takuma
authors: T
authors: Sato
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Takuya
authors: T
authors: Watanabe
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Seiko
authors: S
authors: Nakajima
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Kensuke
authors: K
authors: Kuroda
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Eriko
authors: E
authors: Hisamatsu
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Takamasa
authors: T
authors: Sato
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Masanobu
authors: M
authors: Yanase
authors: Department of Adult Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Hiroki
authors: H
authors: Hata
authors: Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Kyoichi
authors: K
authors: Wada
authors: Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Hatsue
authors: H
authors: Ishibashi-Ueda
authors: Department of Adult Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Junjiro
authors: J
authors: Kobayashi
authors: Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Takeshi
authors: T
authors: Nakatani
mesh_terms: D000328:Adult; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000009:adverse effects*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D055031:Primary Graft Dysfunction / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D066027:Transplant Recipients; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D007166:Immunosuppressive Agents
keywords: Heart transplantation; Marginal donor; Primary graft dysfunction