title: Outpatient follow-up during the first year after heart transplantation, is it feasible?
abstract: BACKGROUND
  First year follow-up after heart transplantation requires invasive tests. Although patients used to be hospitalized for this purpose, ambulatory invasive procedures now offer the possibility of outpatient follow-up. The feasibility and security of this strategy is unknown.
  
  
  METHODS
  From 2007 we transitioned to outpatient follow-up. We have retrospectively reviewed the clinical course of the outpatient group (2007 to 2014) and an inpatient group (2000-2006). Basal characteristics, hospital stay, infections, rejection episodes and vascular complications were evaluated.
  
  
  RESULTS
  87 patients had Inpatient Follow-up (IF) and 98 Outpatient Follow-up (OF). Basal characteristics were similar, with significant differences in immunosuppression (tacrolimus IF 44.8% vs. OF 90.8%, and mycophenolate IF 86.2% vs OF 100%, both p values <0.001) and age (IF 52±11.5years vs. OF 56.1±11years, p=0.016). In the OF group more clinical visits were performed (IF 10 vs. OF 13, p<0.001) while hospital stay was lower (IF 23days vs. OF 3days, p<0.001). The rate of infection, rejection, and vascular complications was similar. No difference was found in 1-year mortality (IF 2.3% vs. 1.0%, p=0.60).
  
  
  CONCLUSIONS
  First year post-cardiac transplantation outpatient follow-up seems to be feasible and safe in terms of infection, rejection, vascular complications and mortality.
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiGM), C/Dr. Esquerdo 46, 28007 Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Ayesta
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiGM), C/Dr. Esquerdo 46, 28007 Madrid, Spain.
authors.forename: Iago
authors.initials: I
authors.lastname: Sousa-Casasnovas
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiGM), C/Dr. Esquerdo 46, 28007 Madrid, Spain.
authors.forename: Edwin
authors.initials: E
authors.lastname: Gómez
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiGM), C/Dr. Esquerdo 46, 28007 Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Universidad Europea de Madrid, Madrid, Spain. Electronic address: mmselles@secardiologia.es.
authors.forename: Manuel
authors.initials: M
authors.lastname: Martínez-Sellés
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiGM), C/Dr. Esquerdo 46, 28007 Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Avilés
mesh_terms: D000328:Adult; D000359:Aftercare / Q000379:methods / Q000458:organization & administration; D000553:Ambulatory Care / Q000379:methods / Q000458:organization & administration; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013030:Spain / Q000453:epidemiology
keywords: Day hospital; Follow-up; Heart transplantation; Outpatient