Re-Exploration for Postoperative Bleeding in Heart Transplantation: Outcomes and Predictors From the Korean Organ Transplantation Registry

Postoperative bleeding requiring surgical re-exploration is a high-impact complication after heart transplantation.Using nationwide registry data from the Korean Organ Transplantation Registry (813 adults, 2014-2021), we found a re-exploration rate of 7.6% and markedly higher all-cause and infection-related mortality, with the excess hazard confined to the first 3 months and converging thereafter.Cardiopulmonary bypass time and preoperative renal replacement therapy independently predicted re-exploration.A simple 2-variable model showed acceptable discrimination (area under the curve=0.77)and was implemented as a nomogram to support individualized perioperative decisions.These findings inform risk stratification, early postoperative management, and counseling in contemporary heart transplantation.