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Cited by 131Transplantation: Methods and OutcomesOrgan Transplantation Techniques and OutcomesCardiac and Coronary Surgery Techniques

What predicts long-term survival after heart transplantation? An analysis of 9,400 ten-year survivors

Kilic, Arman, Weiss, Eric S., George, Timothy J., Arnaoutakis, George J., Yuh, David D., Shah, Ashish S., Conte, John V.·2012·The Annals of Thoracic Surgery
DOI 10.1016/j.athoracsur.2011.09.037
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Abstract

Background This case-control study was conducted to identify factors predictive of 10-year survival after orthotopic heart transplantation (OHT).Methods Prospectively collected data from the United Network for Organ Sharing registry were reviewed to identify adult patients undergoing OHT between 1987 and 1999 (N=22,385) who had survived 10 years. Controls were those who had died within 10 years of OHT. Factors associated with 10-year survival were identified with multivariate logistic regression analysis. Lowess smoothing plots were used to identify linear breakpoints in continuous variables, and splines were incorporated when appropriate.Results There were 9,404 ten-year survivors (42%; mean follow-up, 14.0±3.0 years) and 10,373 controls (46%) with a mean survival of 3.7±3.3 years post-OHT. Predictors of 10-year survival in the optimal multivariate model were age younger than 55 (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.10 to 1.38; p<0.001), white race (OR, 1.35; 95% CI, 1.17 to 1.56; p<0.001), shorter ischemic time (OR, 1.11; 95% CI, 1.05 to 1.18; p<0.001), younger donor age (OR, 1.01; 95% CI, 1.01 to 1.02; p<0.001), annual center volume of 9 or more (OR, 1.31; 95% CI, 1.17 to 1.47; p<0.001), mechanical ventilation (OR, 0.53; 95% CI, 0.36 to 0.78; p=0.001), and diabetes (OR, 0.67; 95% CI, 0.57 to 0.78; p<0.001).Conclusions Age younger than 55 years, annual center volume of 9 or more, white race, shorter ischemic time, and younger donor age improved the likelihood of 10-year survival after OHT. Mechanical ventilation and diabetes reduced this likelihood. These data should serve as a useful guide to long-term prognostication in adult OHT.

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Authors
Kilic, A., Weiss, E. S., George, T. J., Arnaoutakis, G. J., Yuh, D. D., Shah, A. S., & Conte, J. V.
Affiliations
  • Johns Hopkins University (US)
  • Johns Hopkins Hospital (US)
ORCID
Venue
The Annals of Thoracic Surgery
Publisher
Elsevier BV
Published
2012-03
Volume
93
Issue
3
Pages
699-704
ISSN
0003-4975 (ISSN-L)
DOI
10.1016/j.athoracsur.2011.09.037
OpenAlex
W2042384239
Cited by
131
References
25
Citations by year
2026: 3 · 2025: 14 · 2024: 10 · 2023: 9 · 2022: 6 · 2021: 4 · 2020: 13 · 2019: 8 · 2018: 3 · 2017: 8 · 2016: 11 · 2015: 7 · 2014: 14 · 2013: 17 · 2012: 4
FWCI
13.68
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Annals of Thoracic Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Keywords
heart transplantation, long-term survival, transplant recipient characteristics, donor age, donor ischemic time, transplant center volume, mechanical ventilation, diabetes mellitus, race, age, mortality risk factors, United Network for Organ Sharing registry, organ allocation policy, organ shortage, organ procurement, organ donation
MeSH terms
Adult, Aged, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Time Factors, Survival Rate, Case-Control Studies, Heart Transplantation, Survivors

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