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Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?

BACKGROUND: The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL/METHODS: There were 147...

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Autores principales: Sobieszczańska-Małek, Małgorzata, Korewicki, Jerzy, Komuda, Krzysztof, Karczmarz, Małgorzata, Szymańska, Sylwia, Cicha-Mikołajczyk, Alicja, Bekta, Paweł, Parulski, Adam, Pronicki, Maciej, Grajkowska, Wiesława, Małek, Grzegorz, Leszek, Przemysław, Kaczorowska, Maria, Kuśmierczyk, Mariusz, Zieliński, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248309/
https://www.ncbi.nlm.nih.gov/pubmed/29146891
http://dx.doi.org/10.12659/AOT.905267
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author Sobieszczańska-Małek, Małgorzata
Korewicki, Jerzy
Komuda, Krzysztof
Karczmarz, Małgorzata
Szymańska, Sylwia
Cicha-Mikołajczyk, Alicja
Bekta, Paweł
Parulski, Adam
Pronicki, Maciej
Grajkowska, Wiesława
Małek, Grzegorz
Leszek, Przemysław
Kaczorowska, Maria
Kuśmierczyk, Mariusz
Zieliński, Tomasz
author_facet Sobieszczańska-Małek, Małgorzata
Korewicki, Jerzy
Komuda, Krzysztof
Karczmarz, Małgorzata
Szymańska, Sylwia
Cicha-Mikołajczyk, Alicja
Bekta, Paweł
Parulski, Adam
Pronicki, Maciej
Grajkowska, Wiesława
Małek, Grzegorz
Leszek, Przemysław
Kaczorowska, Maria
Kuśmierczyk, Mariusz
Zieliński, Tomasz
author_sort Sobieszczańska-Małek, Małgorzata
collection PubMed
description BACKGROUND: The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL/METHODS: There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest). RESULTS: CAV was recognized in 48 patients (CAV group); mean age 53.6±13.6 years. There were 99 patients without CAV (nonCAV group); mean age 48.3±15.5 years. A univariate Cox analysis of the development of coronary disease showed statistical significance (p<0.05) for baseline high-density lipid (HDL), ACR, AMR, CMV, and donor age. Multivariate Cox regression model confirmed that only baseline HDL, episodes of ACR, donor age, and CMV infection are significant for the frequency of CAV after HT. CONCLUSIONS: Older donor age is highly associated with CAV development. Older donor age and low level of HDL in heart recipients with the strongest influence of immunologic risk factors (ACR, CMV infection) were linked with development of CAV.
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spelling pubmed-62483092018-11-28 Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important? Sobieszczańska-Małek, Małgorzata Korewicki, Jerzy Komuda, Krzysztof Karczmarz, Małgorzata Szymańska, Sylwia Cicha-Mikołajczyk, Alicja Bekta, Paweł Parulski, Adam Pronicki, Maciej Grajkowska, Wiesława Małek, Grzegorz Leszek, Przemysław Kaczorowska, Maria Kuśmierczyk, Mariusz Zieliński, Tomasz Ann Transplant Original Paper BACKGROUND: The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL/METHODS: There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest). RESULTS: CAV was recognized in 48 patients (CAV group); mean age 53.6±13.6 years. There were 99 patients without CAV (nonCAV group); mean age 48.3±15.5 years. A univariate Cox analysis of the development of coronary disease showed statistical significance (p<0.05) for baseline high-density lipid (HDL), ACR, AMR, CMV, and donor age. Multivariate Cox regression model confirmed that only baseline HDL, episodes of ACR, donor age, and CMV infection are significant for the frequency of CAV after HT. CONCLUSIONS: Older donor age is highly associated with CAV development. Older donor age and low level of HDL in heart recipients with the strongest influence of immunologic risk factors (ACR, CMV infection) were linked with development of CAV. International Scientific Literature, Inc. 2017-11-17 /pmc/articles/PMC6248309/ /pubmed/29146891 http://dx.doi.org/10.12659/AOT.905267 Text en © Ann Transplant, 2017 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Original Paper
Sobieszczańska-Małek, Małgorzata
Korewicki, Jerzy
Komuda, Krzysztof
Karczmarz, Małgorzata
Szymańska, Sylwia
Cicha-Mikołajczyk, Alicja
Bekta, Paweł
Parulski, Adam
Pronicki, Maciej
Grajkowska, Wiesława
Małek, Grzegorz
Leszek, Przemysław
Kaczorowska, Maria
Kuśmierczyk, Mariusz
Zieliński, Tomasz
Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?
title Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?
title_full Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?
title_fullStr Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?
title_full_unstemmed Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?
title_short Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?
title_sort heart transplantation and risk of cardiac vasculopathy development: what factors are important?
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248309/
https://www.ncbi.nlm.nih.gov/pubmed/29146891
http://dx.doi.org/10.12659/AOT.905267
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