Cardiac surgical outcomes in abdominal solid organ (renal and hepatic) transplant recipients: a case-matched study

Sharma, Rajiv, Hawley, Carmel, Griffin, Raylene, Mundy, Julie, Peters, Paul and Shah, Pallav (2013) Cardiac surgical outcomes in abdominal solid organ (renal and hepatic) transplant recipients: a case-matched study. Interactive Cardiovascular and Thoracic Surgery, 16 2: 103-111. doi:10.1093/icvts/ivs442

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Author Sharma, Rajiv
Hawley, Carmel
Griffin, Raylene
Mundy, Julie
Peters, Paul
Shah, Pallav
Title Cardiac surgical outcomes in abdominal solid organ (renal and hepatic) transplant recipients: a case-matched study
Journal name Interactive Cardiovascular and Thoracic Surgery   Check publisher's open access policy
ISSN 1569-9293
Publication date 2013-02
Year available 2012
Sub-type Article (original research)
DOI 10.1093/icvts/ivs442
Open Access Status DOI
Volume 16
Issue 2
Start page 103
End page 111
Total pages 9
Place of publication Oxford University Press
Publisher Oxford, England, U.K.
Collection year 2013
Language eng
Formatted abstract
OBJECTIVES This study aims to investigate the outcomes of cardiac surgery in patients with abdominal solid organ transplants and to compare them with the case-matched population undergoing cardiac surgery.

METHODS Data from all transplant recipients abdominal solid organ transplant (ASOT) N = 36 (30 renal and 6 hepatic) who underwent cardiac surgery in a single centre during the period from January 1997 to December 2010 were collected from hospital transplant registries and the cardiac database. The transplant recipients were case matched (CM) with 104 patients in terms of the variables of age, sex and the type of cardiac surgery. Follow-up data were obtained from medical records and by a set of questionnaire through telephonic interviews.

RESULTS Follow-up times were 4.5 ± 3.2 and 3.9 ± 3.2 years in the transplant and CM groups, respectively. Follow-up in the transplant group was 100%. There was no 30-day mortality in the transplant group. Thirty-day combined major morbidities were 9% in the matched group vs 11% in the transplant patients (P = 0.6). Median length of stay was 6 days (inter-quartile range, IQR 5.9) for ASOT vs 5 days (IQR 4.6) for CM (P < 0.01). New dialysis was 8.3% in transplant patients compared with 0.96% in the matched population, while infection was 16.66 vs 0.42% in the CM cohort. There was no allograft failure/dysfunction at the time of death or latest follow-up. Late deaths were 8 of 36 (22%) in ASOT vs 6 of 104 (6%) in CM. Infection (63%) was the most frequent major cause of death in transplant patients. One-, 2-, 5- and 10-year survivals for ASOT vs CM were 94, 88, 80, 59 vs 99, 99, 91, 85%, respectively. Multivariate predictors of mortality were increasing age (hazard ratio, HR 1.1, 95% confidence interval, CI 1.04–1.18; P = 0.003) and solid organ transplantation (HR 3.44, CI 1.19–9.98; P = 0.023).

CONCLUSIONS Cardiac surgery can be performed in patients with abdominal solid organ tranpslant recipients with acceptable early morbidity and mortality. However, long-term survival in transplant patients is poor. Infection remains the most common cause of death.

Keyword Renal transplantation
Liver transplantation
Organ transplantation
Cardiac surgical procedures
Myocardial Revascularization
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes First published online: November 6, 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
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