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Mortality remains high for outpatient transplant candidates with prolonged (>6 months) waiting list time

Aaronson, Keith D ; Mancini, Donna M

Journal of the American College of Cardiology, 1999-04, Vol.33 (5), p.1189-1195 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Mortality remains high for outpatient transplant candidates with prolonged (>6 months) waiting list time
Autor: Aaronson, Keith D ; Mancini, Donna M
Assuntos: Aged ; Biological and medical sciences ; Female ; Follow-Up Studies ; Heart Failure - metabolism ; Heart Failure - mortality ; Heart Failure - surgery ; Heart Transplantation ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardium - metabolism ; Outpatients - statistics & numerical data ; Oxygen Consumption ; Prospective Studies ; Registries - statistics & numerical data ; Risk Factors ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Survival Rate ; Time Factors ; Tissue Donors ; United States - epidemiology ; Waiting Lists
É parte de: Journal of the American College of Cardiology, 1999-04, Vol.33 (5), p.1189-1195
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
Descrição: OBJECTIVES The study aimed to determine the risk of death or urgent transplant for patients who survived an initial 6 months on the outpatient heart transplant waiting list when criteria emphasizing reduced peak oxygen consumption are used for transplant candidate selection. BACKGROUND Waiting time is a key criterion for heart donor allocation. A recent single-center investigation described decreasing survival benefit from transplant for patients who survived an initial 6 months on the outpatient waiting list. METHODS Kaplan-Meier survival analyses were performed for 80 patients from the Hospital of the University of Pennsylvania (HUP) listed from July 1986 to January 1991, and 132 patients from Columbia-Presbyterian Medical Center (CPMC) listed from September 1993 to September 1995. Survival from the time of outpatient listing for the entire group (ALL) was compared to subsequent survival from 6 months onward for those patients who survived the initial 6 months after placement on the outpatient list (6M). Both urgent transplant and left ventricular assist device implantation were considered equivalent to death; elective transplant was censored. RESULTS Survival for 6M was not significantly better than ALL at HUP (subsequent 12 months: 60 ± 7 vs. 60 ± 6% [mean ± SD]; p = 0.89) nor at CPMC (subsequent 12 months: 60 ± 6 vs. 48 ± 5%; p = 0.35). Survival for 6M at both centers was substantially lower than survival following transplant from the outpatient list in the United States in 1995. CONCLUSIONS When high-risk patients are selected for nonurgent transplant listing, mortality remains high, even among those who survive the initial six months after listing. Time accrued on the waiting list remains an appropriate criterion for donor allocation.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Mortality remains high for outpatient transplant candidates with prolonged (>6 months) waiting list time

Aaronson, Keith D ; Mancini, Donna M

New York, NY: Elsevier Inc

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