Clinical characteristics and outcomes of patients with adult congenital heart disease listed for heart and heart‒lung transplantation in the Eurotransplant region
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Clinical characteristics and outcomes of patients with adult congenital heart disease listed for heart and heart‒lung transplantation in the Eurotransplant region. / Becher, Peter Moritz; Schrage, Benedikt; Weimann, Jessica; Smits, Jacqueline; Magnussen, Christina; Reichenspurner, Hermann; Goßling, Alina; Rodrigus, Inez; Dumfarth, Julia; de Pauw, Michel; François, Katrien; van Caenegem, Olivier; Ancion, Arnaut; Van Cleemput, Johan; Milicic, Davor; Moza, Ajay; Schenker, Peter; Röhrich, Luise; Schönrath, Felix; Thul, Josef; Steinmetz, Michael; Schmack, Bastian; Ruhparwar, Arjang; Warnecke, Gregor; Rojas, Sebastian V; Sandhaus, Tim; Haneya, Assad; Eifert, Sandra; Welp, Henryk; Ablonczy, László; Wagner, Florian; Westermann, Dirk; Bernhardt, Alexander M; Knappe, Dorit; Blankenberg, Stefan; Kirchhof, Paulus; Zengin, Elvin; Sinning, Christoph.
In: J HEART LUNG TRANSPL, Vol. 39, No. 11, 11.2020, p. 1238-1249.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Clinical characteristics and outcomes of patients with adult congenital heart disease listed for heart and heart‒lung transplantation in the Eurotransplant region
AU - Becher, Peter Moritz
AU - Schrage, Benedikt
AU - Weimann, Jessica
AU - Smits, Jacqueline
AU - Magnussen, Christina
AU - Reichenspurner, Hermann
AU - Goßling, Alina
AU - Rodrigus, Inez
AU - Dumfarth, Julia
AU - de Pauw, Michel
AU - François, Katrien
AU - van Caenegem, Olivier
AU - Ancion, Arnaut
AU - Van Cleemput, Johan
AU - Milicic, Davor
AU - Moza, Ajay
AU - Schenker, Peter
AU - Röhrich, Luise
AU - Schönrath, Felix
AU - Thul, Josef
AU - Steinmetz, Michael
AU - Schmack, Bastian
AU - Ruhparwar, Arjang
AU - Warnecke, Gregor
AU - Rojas, Sebastian V
AU - Sandhaus, Tim
AU - Haneya, Assad
AU - Eifert, Sandra
AU - Welp, Henryk
AU - Ablonczy, László
AU - Wagner, Florian
AU - Westermann, Dirk
AU - Bernhardt, Alexander M
AU - Knappe, Dorit
AU - Blankenberg, Stefan
AU - Kirchhof, Paulus
AU - Zengin, Elvin
AU - Sinning, Christoph
N1 - Copyright © 2020 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
PY - 2020/11
Y1 - 2020/11
N2 - BACKGROUND: The therapeutic success in patients with congenital heart disease (CHD) leads to a growing number of adults with CHD (adult CHD [ACHD]) who develop end-stage heart failure. We aimed to determine patient characteristics and outcomes of ACHD listed for heart transplantation.METHODS: Using data from all the patients with ACHD in 20 transplant centers in the Eurotransplant region from 1999 to 2015, we analyzed patient characteristics, waiting list, and post-transplantation outcomes.RESULTS: A total of 204 patients with ACHD were listed during the study period. The median age was 38 years, and 62.3% of the patients were listed in high urgency (HU), and 37.7% of the patients were in transplantable (T)-listing status. A total of 23.5% of the patients died or were delisted owing to clinical worsening, and 75% of the patients underwent transplantation. Median waiting time for patients with HU-listing status was 4.18 months and with T-listing status 9.07 months. There was no difference in crude mortality or delisting between patients who were HU status listed and T status listed (p = 0.65). In multivariable regression analysis, markers for respiratory failure (mechanical ventilation, hazard ratio [HR]: 1.41, 95% CI: 1.11-1.81, p = 0.006) and arrhythmias (anti-arrhythmic medication, HR: 1.42, 95% CI: 1.01-2.01, p = 0.044) were associated with a higher risk of death or delisting. In the overall cohort, post-transplantation mortality was 26.8% after 1 year and 33.4% after 5 years.CONCLUSIONS: Listed patients are at high risk of death without differences in the urgency of listing. Respiratory failure requiring invasive ventilation and possibly arrhythmias requiring anti-arrhythmic medication indicate worse outcomes on waiting list.
AB - BACKGROUND: The therapeutic success in patients with congenital heart disease (CHD) leads to a growing number of adults with CHD (adult CHD [ACHD]) who develop end-stage heart failure. We aimed to determine patient characteristics and outcomes of ACHD listed for heart transplantation.METHODS: Using data from all the patients with ACHD in 20 transplant centers in the Eurotransplant region from 1999 to 2015, we analyzed patient characteristics, waiting list, and post-transplantation outcomes.RESULTS: A total of 204 patients with ACHD were listed during the study period. The median age was 38 years, and 62.3% of the patients were listed in high urgency (HU), and 37.7% of the patients were in transplantable (T)-listing status. A total of 23.5% of the patients died or were delisted owing to clinical worsening, and 75% of the patients underwent transplantation. Median waiting time for patients with HU-listing status was 4.18 months and with T-listing status 9.07 months. There was no difference in crude mortality or delisting between patients who were HU status listed and T status listed (p = 0.65). In multivariable regression analysis, markers for respiratory failure (mechanical ventilation, hazard ratio [HR]: 1.41, 95% CI: 1.11-1.81, p = 0.006) and arrhythmias (anti-arrhythmic medication, HR: 1.42, 95% CI: 1.01-2.01, p = 0.044) were associated with a higher risk of death or delisting. In the overall cohort, post-transplantation mortality was 26.8% after 1 year and 33.4% after 5 years.CONCLUSIONS: Listed patients are at high risk of death without differences in the urgency of listing. Respiratory failure requiring invasive ventilation and possibly arrhythmias requiring anti-arrhythmic medication indicate worse outcomes on waiting list.
U2 - 10.1016/j.healun.2020.07.012
DO - 10.1016/j.healun.2020.07.012
M3 - SCORING: Journal article
C2 - 32778365
VL - 39
SP - 1238
EP - 1249
JO - J HEART LUNG TRANSPL
JF - J HEART LUNG TRANSPL
SN - 1053-2498
IS - 11
ER -
