What is the clinical evidence from this study?

Study design: Cohort. Population: End-stage heart cardiomyopathy (n=345). Intervention: Urgent heart transplantation (status I) vs. Elective heart transplantation. Primary outcome: Actuarial survival at six years (p=0.04).

What question did this study set out to answer?

To evaluate long-term survival and clinical outcomes in patients undergoing orthotopic heart transplantation for end-stage cardiomyopathy.

May 1, 2003Journal of Cardiac Surgery

Long-Term Results of Cardiac Transplantation

Q: What does this research mean for the field?

Urgent heart transplantation (status I) is associated with significantly lower long-term actuarial survival compared to elective transplantation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Urgent heart transplantation linked to ~9% lower 6-year survival versus elective transplantation.

P=0.04
n=345

Population

n=345 patients with end-stage heart cardiomyopathy who underwent heart transplantation at Juan Canalejo…

Design

Cohort

Follow-up

up to 6 years

Authors

AJAlberto JufféComplexo Hospitalario Universitario A Coruña MRMiguel RodríguezUniversity of California, Riverside ECEnrico CaputoAgenzia Regionale Sanitaria della Puglia

Discussion

Member takes

Implication

Urgent status I recipients face higher long-term mortality; leaves open whether refined allocation improves equity in transplant outcomes.

Key Points

To evaluate long-term survival and clinical outcomes in patients undergoing orthotopic heart transplantation for end-stage cardiomyopathy.
Single-center observational cohort study of N=345 patients (mean age 54.5 ± 11.4 years; 83% male) undergoing heart transplantation between April 1991 and December 2000.
Assessed elective versus urgent (status I, 11.5%) transplant procedures and evaluated actuarial survival across donor and recipient clinical variables.
Operative (30-day), 1-year, and 6-year survival was 87.2%, 81.3%, and 64%, respectively, while in-hospital mortality was 10.6% for elective versus 24% for urgent transplantation.
Actuarial 6-year survival was significantly higher in elective versus urgent transplants (66% vs 57%, p = 0.04) and in recipients of male versus female donor grafts (72% vs 59%, p = 0.05).
Recipient age, sex, prior cardiac surgery, and etiology of end-stage cardiomyopathy showed no significant differences in actuarial survival.

Study Design

Type

Cohort (n=345)

Multicenter

Structured PICO

Population

345 patients (83% male, mean age 54.5 years) with end-stage heart cardiomyopathy who underwent heart transplantation, followed for up to 6 years.

Exposure

Orthotopic heart transplantation

Outcome

Long-term survival (operative/30-day, one-year, and six-year)hard clinical

Main Result

Absolute Event Rate: 57% vs 66%

p-value: p=0.04

Orthotopic heart transplantation provides good long-term survival, though urgent status (status I) and receiving a heart from a female donor are associated with higher mortality.

Cite This Study

Juffé et al. (2003) conducted a cohort in End-stage heart cardiomyopathy (n=345). Urgent heart transplantation (status I) vs. Elective heart transplantation was evaluated on Actuarial survival at six years (p=0.04). Urgent heart transplantation (status I) was associated with significantly lower 6-year actuarial survival compared to elective transplantation (57% vs 66%, p=0.04).

synapsesocial.com/papers/6aa4dcd26ab07c8cae811a4d https://doi.org/10.1046/j.1540-8191.2003.02024.x

Topics

Heart transplantation

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Implication

Urgent status I recipients face higher long-term mortality; leaves open whether refined allocation improves equity in transplant outcomes.

Long-Term Results of Cardiac Transplantation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Long-Term Results of Cardiac Transplantation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

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