title: Clinical Factors Implicated in Primary Graft Dysfunction After Heart Transplantation: A Single-center Experience.
abstract: BACKGROUND
  Primary graft dysfunction (PGD) is a frequent complication after cardiac transplantation and remains one of the leading causes of mortality in these patients. The objective of this case-control study is to identify donor and surgical procedure's factors associated with PGD, and further guide possible strategies to prevent PGD.
  
  
  METHODS
  Retrospective analysis of the medical records of patients who underwent cardiac transplantation at Memorial Hermann Hospital at Texas Medical Center between October 2012 and February 2015.
  
  
  RESULTS
  The study population included 99 patients, of which 18 developed PGD. Univariate analysis of donor characteristics revealed opioid use (P = .049) and death owing to anoxia (P = .021) were associated with PGD. The recipient/donor blood type match AB/A was significantly associated with PGD (P = .031). Time from brain death to aortic cross clamp (TBDACC) of ≥3 and ≥5 days were also found to be associated with PGD (P = .0011 and .0003, respectively). Multivariate analysis confirmed that patients with a time from brain death to aortic cross clamp ≥3 and ≥5 days had lesser odds of developing PGD (odds ratio, 0.098 [P = .0026] and OR, 0.092 [P = .0017], respectively].
  
  
  CONCLUSIONS
  Our study showed that a longer time from brain death to aortic cross clamp was associated with lower odds of developing PGD. Therefore, postponing heart procurement for a few days after brain death seems to be beneficial in preventing PGD.
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas. Electronic address: Raymundo.A.Quintanaquezada@uth.tmc.edu.
authors: R A
authors: RA
authors: Quintana-Quezada
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: I
authors: I
authors: Rajapreyar
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: A
authors: A
authors: Postalian-Yrausquin
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: Y C
authors: YC
authors: Yeh
authors: Division of Clinical and Translational Sciences, Department of Internal Medicine, University of Texas Medical School at Houston, Houston, Texas.
authors: S
authors: S
authors: Choi
authors: Division of Critical Care, Pulmonary and Sleep, University of Texas Medical School at Houston, Houston, Texas.
authors: B
authors: B
authors: Akkanti
authors: Department of Pharmacy, Memorial Hermann - Texas Medical Center, Houston, Texas.
authors: A
authors: A
authors: Sieg
authors: Department of Pharmacy, Memorial Hermann - Texas Medical Center, Houston, Texas.
authors: P
authors: P
authors: Weeks
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: M
authors: M
authors: Patel
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: J
authors: J
authors: Patel
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: S
authors: S
authors: Nathan
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: B
authors: B
authors: Kar
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: P
authors: P
authors: Loyalka
authors: Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital, Texas Medical Center, Houston, Texas.
authors: I
authors: I
authors: Gregoric
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D001926:Brain Death; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology*; D055031:Primary Graft Dysfunction / Q000097:blood / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System