1
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Olivella A, Almenar-Bonet L, González-Vilchez F, Díez-López C, Díaz-Molina B, Blázquez-Bermejo Z, Sobrino-Márquez JM, Gómez-Bueno M, Garrido-Bravo IP, Barge-Caballero E, Farrero-Torres M, García-Cosio MD, Blasco-Peiró T, Pomares-Varó A, Muñiz J, González-Costello J. Mechanical circulatory support in severe primary graft dysfunction: Peripheral cannulation but not earlier implantation improves survival in heart transplantation. J Heart Lung Transplant 2023; 42:1101-1111. [PMID: 37019730 DOI: 10.1016/j.healun.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/23/2023] [Accepted: 03/05/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Primary graft dysfunction (PGD) still affects 2% to 28% of heart transplants (HT). Severe PGD requires mechanical circulatory support (MCS) and is the main cause of death early after HT. Earlier initiation has been suggested to improve prognosis but the best cannulation strategy is unknown. METHODS Analysis of all HT in Spain between 2010 and 2020. Early (<3 hours after HT) vs late initiation (≥3 hours after HT) of MCS was compared. Special focus was placed on peripheral vs central cannulation strategy. RESULTS A total of 2376 HT were analyzed. 242 (10.2%) suffered severe PGD, 171 (70.7%) received early MCS and 71 (29.3%) late MCS. Baseline characteristics were similar. Patients with late MCS had higher inotropic scores and worse renal function at the moment of cannulation. Early MCS had longer cardiopulmonary bypass times and late MCS was associated with more peripheral vascular damage. No significant differences in survival were observed between early and late implant at 3 months (43.82% vs 48.26%; log-rank p = 0.59) or at 1 year (39.29% vs 45.24%, log-rank p = 0.49). Multivariate analysis did not show significant differences favoring early implant. Survival was higher in peripheral compared to central cannulation at 3 months (52.74% vs 32.42%, log-rank p = 0.001) and 1 year (48.56% vs 28.19%, log-rank p = 0.0007). In the multivariate analysis, peripheral cannulation remained a protective factor. CONCLUSIONS Earlier MCS initiation for PGD was not superior, compared to a more conservative approach with deferred initiation. Peripheral compared to central cannulation showed superior 3-month and 1-year survival rates.
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Affiliation(s)
- Aleix Olivella
- Heart Failure Unit, Cardiology Department, Hospital Universitari Vall d'Hebrón, Vall d'Hebrón Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Almenar-Bonet
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Heart Failure and Transplant Unit, Cardiology department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Francisco González-Vilchez
- Departamento de Medicina y Psiquiatría. Universidad de Cantabria. Grupo de Investigación Cardiovascular del Instituto de Investigación Valdecilla (IDIVAL), Cardiology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Carles Díez-López
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Advanced Heart Failure and Transplant Unit, Department of Cardiology, Hospital Universitari de Bellvitge. BIOHEART-Cardiovascular diseases group; Cardiovascular, Respiratory and Systemic Diseases and cellular aging Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Beatriz Díaz-Molina
- Heart Failure and Transplant Unit, Cardiology Department, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria Principado de Asturias, ISPA, Spain
| | - Zorba Blázquez-Bermejo
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Cardiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - José Manuel Sobrino-Márquez
- Heart Failure and Transplant Unit, Cardiology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Manuel Gómez-Bueno
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Heart Failure, Transplant and Pulmonary Hypertension Unit, Cardiology department, Hospital Puerta de Hierro de Majadahonda, Madrid, Spain
| | - Iris P Garrido-Bravo
- Heart Failure and Transplant Unit, Cardiology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Eduardo Barge-Caballero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Cardiology Department, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Marta Farrero-Torres
- Heart Failure and Transplant Unit, Cardiology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria Dolores García-Cosio
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Teresa Blasco-Peiró
- Heart Failure and Transplant Unit, Cardiology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Javier Muñiz
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Grupo de Investigación Cardiovascular, Departamento de Ciencias de la Salud e Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, Spain
| | - José González-Costello
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Advanced Heart Failure and Transplant Unit, Department of Cardiology, Hospital Universitari de Bellvitge. BIOHEART-Cardiovascular diseases group; Cardiovascular, Respiratory and Systemic Diseases and cellular aging Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
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2
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Ortiz-Bautista C, Muñiz J, Almenar-Bonet L, Crespo-Leiro MG, Sobrino-Márquez JM, Farrero-Torres M, García-Cosio MD, Díaz-Molina B, Zegrí-Reiriz I, González-Vilchez F, Blázquez-Bermejo Z, López Granados A, Gómez-Bueno M, de la Fuente-Galán L, Blasco-Peiró T, Garrido-Bravo IP, García-Romero E, Rábago Juan-Aracil G, García-Guereta L, Delgado-Jiménez JF. Utility of the IMPACT score for predicting heart transplant mortality. Analysis on a contemporary cohort of the Spanish Heart Transplant Registry. Clin Transplant 2022; 36:e14774. [PMID: 35829691 DOI: 10.1111/ctr.14774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES The Index for Mortality Prediction After Cardiac Transplantation (IMPACT) score was derived and validated as a predictor of mortality after heart transplantation (HT). The primary objective of this work is to externally validate the IMPACT score in a contemporary Spanish cohort. METHODS Spanish Heart Transplant Registry data were used to identify adult (>16 years) HT patients between January 2000 and December 2015. Retransplantation, multiorgan transplantation and patients in whom at least one of the variables required to calculate the IMPACT score was missing were excluded from the analysis (N = 2,810). RESULTS Median value of the IMPACT score was 5 points (IQR: 3, 8). Overall 1-year survival rate was 79.1%. Kaplan-Meier 1-year survival rates by IMPACT score categories (0-2, 3-5, 6-9, 10-14, ≥ 15) were 84.4%, 81.5%, 79.3%, 77.3% and 58.5% respectively (Log-Rank test: p<0.001). Performance analysis showed a good calibration (Hosmer-Lemeshow chi-square for one year was 7.56; p = 0.47) and poor discrimination ability (AUC-ROC 0.59) of the IMPACT score as a predictive model. CONCLUSIONS In a contemporary Spanish cohort, the IMPACT score failed to accurately predict the risk of death after HT. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Carlos Ortiz-Bautista
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Muñiz
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Universidade da Coruña, Grupo de Investigación Cardiovascular, Departamento de Ciencias de la Salud e Instituto de Investigación Biomédica (INIBIC), A Coruña, Spain
| | - Luis Almenar-Bonet
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Unidad de Insuficiencia Cardíaca y Trasplante, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - María G Crespo-Leiro
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), A Coruña, Spain
| | - José M Sobrino-Márquez
- Unidad de Insuficiencia Cardíaca y Trasplante, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Marta Farrero-Torres
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Hospital Clínic, Barcelona, Spain
| | - María D García-Cosio
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Cardiología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - Beatriz Díaz-Molina
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Isabel Zegrí-Reiriz
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Institute of Biomedical Research IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francisco González-Vilchez
- Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain
| | - Zorba Blázquez-Bermejo
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Manuel Gómez-Bueno
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Unidad de Insuficiencia cardiaca avanzada y Trasplante, Servicio de Cardiología, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, Spain
| | - Luis de la Fuente-Galán
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Unidad de Insuficiencia Cardiaca Avanzada y Trasplante, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Teresa Blasco-Peiró
- Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Iris P Garrido-Bravo
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Elena García-Romero
- Servicio de Cardiología, Hospital Universitari de Bellvitge, BIOHEART-Cardiovascular Diseases group, Cardiovascular, Respiratory and Systemic Diseases and cellular aging program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Juan F Delgado-Jiménez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Cardiología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
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3
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Salterain-González N, Rábago Juan-Aracil G, Gómez-Bueno M, Almenar-Bonet L, Crespo-Leiro MG, Arizón del Prado JM, García-Cosío MD, Martínez-Sellés M, Mirabet-Pérez S, Sobrino-Márquez JM, González-Costello J, Pérez-Villa F, Díaz-Molina B, de la Fuente-Galán L, Blasco-Peiró T, Garrido-Bravo IP, García-Guereta Silva L, Gil-Villanueva N, Gran F, González-Vilchez F. Resultados del retrasplante cardiaco: subanálisis del Registro Español de Trasplante Cardiaco. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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4
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Salterain-González N, Rábago Juan-Aracil G, Gómez-Bueno M, Almenar-Bonet L, Crespo-Leiro MG, Arizón Del Prado JM, García-Cosío MD, Martínez-Sellés M, Mirabet-Pérez S, Sobrino-Márquez JM, González-Costello J, Pérez-Villa F, Díaz-Molina B, de la Fuente-Galán L, Blasco-Peiró T, Garrido-Bravo IP, García-Guereta Silva L, Gil-Villanueva N, Gran F, González-Vilchez F. Results of heart retransplantation: subanalysis of the Spanish Heart Transplant Registry. Rev Esp Cardiol (Engl Ed) 2022; 75:60-66. [PMID: 34253459 DOI: 10.1016/j.rec.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION AND OBJECTIVES Heart retransplantation (ReHT) is controversial in the current era. The aim of this study was to describe and analyze the results of ReHT in Spain. METHODS We performed a retrospective cohort analysis from the Spanish Heart Transplant Registry from 1984 to 2018. Data were collected on donors, recipients, surgical procedure characteristics, immunosuppression, and survival. The main outcome was posttransplant all-cause mortality or need for ReHT. We studied differences in survival according to indication for ReHT, the time interval between transplants and era of ReHT. RESULTS A total of 7592 heart transplants (HT) and 173 (2.3%) ReHT were studied (median age, 52.0 and 55.0 years, respectively). Cardiac allograft vasculopathy was the most frequent indication for ReHT (42.2%) and 59 patients (80.8%) received ReHT >5 years after the initial transplant. Acute rejection and primary graft failure decreased as indications over the study period. Renal dysfunction, hypertension, need for mechanical ventilation or intra-aortic balloon pump and longer cold ischemia time were more frequent in ReHT. Median follow-up for ReHT was 5.8 years. ReHT had worse survival than HT (weighted HR, 1.43; 95%CI, 1.17-1.44; P<.001). The indication of acute rejection (HR, 2.49; 95%CI, 1.45-4.27; P<.001) was related to the worst outcome. ReHT beyond 5 years after initial HT portended similar results as primary HT (weighted HR, 1.14; 95%CI, 0.86-1.50; P<.001). CONCLUSIONS ReHT was associated with higher mortality than HT, especially when indicated for acute rejection. ReHT beyond 5 years had a similar prognosis to primary HT.
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Affiliation(s)
| | | | - Manuel Gómez-Bueno
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Luis Almenar-Bonet
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Universitat de València, Valencia, Spain
| | - María Generosa Crespo-Leiro
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Complexo Hospitalario Universitario A Coruña (CHUAC), Instituto de Investigación Biomédica A Coruña (INIBIC), Universidade da Coruña (UDC), A Coruña, Spain
| | | | - María Dolores García-Cosío
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Manuel Martínez-Sellés
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Madrid, Spain; Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Sonia Mirabet-Pérez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardiaca y Programa de Trasplante Cardiaco, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - José González-Costello
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Servicio de Cardiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Félix Pérez-Villa
- Unidad de Insuficiencia Cardiaca, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Beatriz Díaz-Molina
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardico, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Luis de la Fuente-Galán
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Teresa Blasco-Peiró
- Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Iris P Garrido-Bravo
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | | | - Nuria Gil-Villanueva
- Unidad de Insuficiencia Cardiaca y Trasplante, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - Ferrán Gran
- Servicio Cardiología pediátrica, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Francisco González-Vilchez
- Unidad de Insuficiencia Cardiaca y Transplante, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
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5
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García-Cosío MD, González-Vilchez F, López-Vilella R, Barge-Caballero E, Gómez Bueno M, Martínez-Selles M, María Arizón J, Rangel Sousa D, González-Costello J, Mirabet S, Pérez-Villa F, Molina BD, Rábago G, Portolés Ocampo A, de la Fuente Galán L, Garrido I, Delgado JF. Influence of Gender in Advanced Heart Failure Therapies and Outcome Following Transplantation. Front Cardiovasc Med 2021; 8:630113. [PMID: 33718453 PMCID: PMC7946818 DOI: 10.3389/fcvm.2021.630113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022] Open
Abstract
Biological differences between males and females change the course of different diseases and affect therapeutic measures' responses. Heart failure is not an exception to these differences. Women account for a minority of patients on the waiting list for heart transplantation or other advanced heart failure therapies. The reason for this under-representation is unknown. Men have a worse cardiovascular risk profile and suffer more often from ischemic heart disease. Conversely, transplanted women are younger and more frequently have non-ischemic cardiac disorders. Women's poorer survival on the waiting list for heart transplantation has been previously described, but this trend has been corrected in recent years. The use of ventricular assist devices in women is progressively increasing, with comparable results than in men. The indication rate for a heart transplant in women (number of women on the waiting list for millions of habitants) has remained unchanged over the past 25 years. Long-term results of heart transplants are equal for both men and women. We have analyzed the data of a national registry of heart transplant patients to look for possible future directions for a more in-depth study of sex differences in this area. We have analyzed 1-year outcomes of heart transplant recipients. We found similar results in men and women and no sex-related interactions with any of the factors related to survival or differences in death causes between men and women. We should keep trying to approach sex differences in prospective studies to confirm if they deserve a different approach, which is not supported by current evidence.
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Affiliation(s)
- María Dolores García-Cosío
- Servicio de Cardiología, Hospital 12 de Octubre Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain
| | | | - Raquel López-Vilella
- Servicio de Cardiología, Hospital Universitari i Politecnic La Fe, Valencia, Spain
| | - Eduardo Barge-Caballero
- Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain
- Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Manuel Gómez Bueno
- Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Manuel Martínez-Selles
- Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Universidad Europea, Universidad Complutense, Madrid, Spain
| | - Jose María Arizón
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Cordoba, Spain
| | - Diego Rangel Sousa
- Servicio de Cardiología, Hospital Universitario Virgen Del Rocío, Seville, Spain
| | - José González-Costello
- Servicio de Cardiología, Hospital Universitari De Bellvitge, Hospitalet de Llobregat, Spain
| | - Sonia Mirabet
- Servicio de Cardiología, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Félix Pérez-Villa
- Servicio de Cardiología, Hospital Clínic i Provincial, Barcelona, Spain
| | - Beatriz Díaz Molina
- Servicio de Cardiología, Hospital Universitario Central De Asturias, Oviedo, Spain
| | - Gregorio Rábago
- Servicio de Cirugía Cardiaca, Clínica Universidad De Navarra, Navarra, Spain
| | - Ana Portolés Ocampo
- Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Iris Garrido
- Servicio de Cardiología, Hospital Universitario Virgen De La Arrixaca, Murcia, Spain
| | - Juan F. Delgado
- Servicio de Cardiología, Hospital 12 de Octubre Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain
- Departamento de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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6
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García-Cosío MD, González-Vilchez F, López-Vilella R, Barge-Caballero E, Gómez-Bueno M, Martínez-Selles M, Arizón JM, Rangel Sousa D, González-Costello J, Mirabet S, Pérez-Villa F, Díaz-Molina B, Rábago G, Portolés Ocampo A, de la Fuente-Galán L, Garrido I, Delgado-Jiménez JF. Gender differences in heart transplantation: Twenty-five year trends in the nationwide Spanish heart transplant registry. Clin Transplant 2020; 34:e14096. [PMID: 32978995 DOI: 10.1111/ctr.14096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 09/05/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022]
Abstract
The study of gender differences may lead into improvement in patient care. We have aimed to identify the gender differences in heart transplantation (HT) of adult HT recipients in Spain and their evolution in a study covering the years 1993-2017 in which 6740 HT (20.6% in women) were performed. HT indication rate per million inhabitants was lower in women, remaining basically unchanged during the 25-year study period. HT rate was higher in men, although this decreased over the 25-year study period. Type of heart disease differed in men versus women (p < .001): ischemic heart disease 47.6% versus 22.5%, dilated cardiomyopathy 41.3% versus 34.6%, or other 36% versus 17.8%, respectively. Men were more frequently diabetics (18% vs. 13.1% p < .001), hypertensives (33.1% vs. 24% p < .001), and smokers (21.7% vs. 12.9% p < .001), respectively. Women had more pre-HT malignancies (7.1% vs. 2.8% p < .001), and their clinical status was worse at HT due to renal function and mechanical ventilation. Adjusted survival (p = .198) and most of the mortality-related variables were similar in men and women. Death occurred more frequently in women due to rejection (7.9% vs. 5.1% p < .001) and primary failure (18.2% vs. 12.5% p < .001) and in men due to malignancies (15.1% vs. 6.6% p < .001).
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Affiliation(s)
- María D García-Cosío
- Department of Cardiology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain.,Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain
| | | | - Raquel López-Vilella
- Department of Cardiology, Hospital Universitari I Politecnic La Fe, Valencia, Spain
| | | | - Manuel Gómez-Bueno
- Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Manuel Martínez-Selles
- Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain.,Department of Cardiology, Hospital General Universitario Gregorio Marañón, Universidad Europea, Universidad Complutense, Madrid, Spain
| | - Jose M Arizón
- Department of Cardiology, Hospital Universitario Reina Sofía, Cordoba, Spain
| | - Diego Rangel Sousa
- Department of Cardiology, Hospital Universitario Virgen Del Rocío, Sevilla, Spain
| | - José González-Costello
- Department of Cardiology, Hospital Universitari De Bellvitge, Hospitalet de Llobregat, Spain
| | - Sonia Mirabet
- Department of Cardiology, Hospital Santa Creu I Sant Pau, Barcelona, Spain
| | - Félix Pérez-Villa
- Department of Cardiology, Hospital Clínic I Provincial, Barcelona, Spain
| | - Beatriz Díaz-Molina
- Department of Cardiology, Hospital Universitario Central De Asturias, Oviedo, Spain
| | - Gregorio Rábago
- Department of Cardiac Surgery, Clínica Universidad De Navarra, Navarra, Spain
| | - Ana Portolés Ocampo
- Department of Cardiology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Iris Garrido
- Department of Cardiology, Hospital Universitario Virgen De La Arrixaca, Murcia, Spain
| | - Juan F Delgado-Jiménez
- Department of Cardiology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain.,Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain.,Medicine Department, Universidad Complutense de Madrid, Madrid, Spain
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7
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González-Vilchez F, Almenar-Bonet L, Crespo-Leiro MG, Gómez-Bueno M, González-Costello J, Pérez-Villa F, Delgado-Jiménez J, Arizón Del Prado JM, Sobrino-Márquez JM, Sousa Casasnovas I, Segovia-Cubero J, Hernández-Pérez F, Martínez Penades S, Cebrián Pinar M, López Vilella R, Sánchez-Lázaro I, Martínez-Dolz L, Paniagua-Martín MJ, Barge-Caballero E, Barge-Caballero G, Couto-Mallón D, López Granados A, Segura Saintgerons C, Menjíbar Pareja V, Carrasco Ávalos F, Cobo M, Llano-Cardenal M, Vázquez de Prada JA, Nistal Herrera F, Blázquez Z, Jesús Valero M, Ortiz C, Zataraín E, Villa A, Navas P, Martínez-Sellés M, Dolores García Cosío M, Morán Fernández L, Caravaca P, Brossa Loidi V, Roig Minguell E, Mirabet Pérez S, López López L, Zegrí I, Rangel Sousa D, Manito Lorite N, Díez Lopez C, Roca Elias J, García Romero E, Rábago Juan-Aracil G, Castel MÁ, Farrero M, Lambert Rodríguez JL, Díaz Molina B, Bernardo Rodríguez MJ, Fidalgo Muñiz C, Camino López M, Gil Jaurena JM, Gil Villanueva N, Garrido-Bravo I, Pascual Figal DA, Pastor Pérez FJ, Blasco-Peiró T, Portoles Ocampo A, Sanz Julve M, de la Fuente Galán L, Tobar Ruiz J, Recio Platero A, García-Guereta Silva L, González Rocafort Á, Labradero de Lera C, Polo López L, Gran Ipiña F, Albert Brotons DC, Abella Antón R, García Quintana A, Groba Marco MDV. Spanish Heart Transplant Registry. 31th Official Report of the Heart Failure Association of the Spanish Society of Cardiology. ACTA ACUST UNITED AC 2020; 73:919-926. [PMID: 33041239 DOI: 10.1016/j.rec.2020.06.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND OBJECTIVES The present report describes the clinical characteristics and outcomes of heart transplants in Spain and updates the data to 2019. METHODS We describe the clinical characteristics and outcomes of heart transplants performed in Spain in 2019, as well as trends in this procedure from 2010 to 2018. RESULTS In 2019, 300 transplants were performed (8794 since 1984; 2745 between 2010 and 2019). Compared with previous years, the most notable findings were the decreasing rate of urgent transplants (38%), and the consolidation of the type of circulatory support prior to transplant, with an almost complete disappearance of counterpulsation balloon (0.7%), stabilization in the use of extracorporeal membrane oxygenation (9.6%), and an increase in the use of ventricular assist devices (29.0%). Survival from 2016 to 2018 was similar to that from 2013 to 2015 (P=.34). Survival in both these periods was better than that from 2010 to 2012 (P=.002 and P=.01, respectively). CONCLUSIONS Heart transplant activity has remained stable during the last few years, as have outcomes (in terms of survival). There has been a trend to a lower rate of urgent transplants and to a higher use of ventricular assist devices prior to transplant.
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Affiliation(s)
| | - Luis Almenar-Bonet
- Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - María G Crespo-Leiro
- Servicio de Cardiología, Complexo Hospitalario Universitario A Coruña (CHUAC), Universidade da Coruña (UDC), Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Manuel Gómez-Bueno
- Departamento de Cardiología, Hospital Universitario Clínica Puerta de Hierro, Majadahonda, Madrid, Spain
| | - José González-Costello
- Servei de Cardiologia, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Félix Pérez-Villa
- Servei de Cardiologia, Hospital Clínic Universitari, Barcelona, Spain
| | - Juan Delgado-Jiménez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Fundación Investigación Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Manuel Cobo
- Hospital Universitario Marqués de Valdecilla, Santander, Cantabria
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Carles Díez Lopez
- Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona
| | - Josep Roca Elias
- Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona
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8
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Barge-Caballero E, González-Vilchez F, Farrero-Torres M, Segovia-Cubero J. Selección de lo mejor del año 2017 en trasplante cardiaco y asistencia ventricular. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Barge-Caballero E, González-Vilchez F, Farrero-Torres M, Segovia-Cubero J. Selection of the Best of 2017 in Cardiac Transplant and Ventricular Assist Devices. ACTA ACUST UNITED AC 2018; 71:300-301. [PMID: 29398583 DOI: 10.1016/j.rec.2017.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 10/09/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Eduardo Barge-Caballero
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidad de A Coruña (UDC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
| | | | | | - Javier Segovia-Cubero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
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10
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Crespo-Leiro M, Segovia Cubero J, Delgado-Jiménez J, Roig-Minguell E, Barge-Caballero E, Sousa-Casasnovas I, Almenar-Bonet L, González-Vilchez F, González-Costello J, Díaz-Molina B, Sobrino-Márquez J, Rábago G, Arizón del Prado J, Pérez-Villa F, Blasco Peiró T, de la Fuente-Galán L, Garrido Bravo I, Muñiz J. Neoplasia after Heart Transplantation. Differences in Incidence and Prognosis between Genders. Data from the Spanish Post-Heart Transplant Tumor Registry. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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11
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Delgado J, Almenar L, González-Vilchez F, Arizón J, Gómez M, Fuente L, Brossa V, Fernández J, Díaz B, Pascual D, Lage E, Sanz M, Manito N, Crespo-Leiro M. Health-related quality of life, social support, and caregiver burden between six and 120 months after heart transplantation: a Spanish multicenter cross-sectional study. Clin Transplant 2015; 29:771-80. [DOI: 10.1111/ctr.12578] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 11/29/2022]
Affiliation(s)
- J.F. Delgado
- Hospital Universitario 12 de Octubre; Madrid Spain
| | - L. Almenar
- Hospital Universitario La Fe; Valencia Spain
| | | | - J.M. Arizón
- Hospital Universitario Reina Sofía; Córdoba Spain
| | - M. Gómez
- Hospital Universitario Puerta de Hierro; Madrid Spain
| | - L. Fuente
- Hospital Clínico Universitario de Valladolid; Valladolid Spain
| | - V. Brossa
- Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - J. Fernández
- Hospital Universitario Gregorio Marañón; Madrid Spain
| | - B. Díaz
- Hospital Universitario Central de Asturias; Oviedo Spain
| | - D. Pascual
- Hospital Universitario Virgen de la Arrixaca; Murcia Spain
| | - E. Lage
- Hospital Universitario Virgen del Rocío; Seville Spain
| | - M. Sanz
- Hospital Universitario Miguel Servet; Zaragoza Spain
| | - N. Manito
- Hospital Universitario de Bellvitge; Barcelona Spain
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12
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Barge-Caballero E, Segovia-Cubero J, González-Vilchez F, Delgado-Jiménez J, Pérez-Villa F, Almenar-Bonet L, Arizón-Del Prado JL, Lage-Gallé E, De La Fuente-Galán L, Manito-Lorite N, Sanz-Julve M, Villa-Arranz A, Lambert Rodríguez JL, Brossa-Loidi V, Pascual-Figal D, Muñiz-García J, Crespo-Leiro M. Evaluation of the preoperative vasoactive-inotropic score as a predictor of postoperative outcomes in patients undergoing heart transplantation. Int J Cardiol 2015; 185:192-4. [DOI: 10.1016/j.ijcard.2015.03.098] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 03/08/2015] [Indexed: 11/15/2022]
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Crespo-Leiro MG, Delgado-Jiménez J, López L, Alonso-Pulpón L, González-Vilchez F, Almenar-Bonet L, Rábago G, Pérez-Villa F, Paniagua Martín MJ, Arizón del Prado JM, Sousa-Casasnovas I, Manito-Lorite N, Díaz-Molina B, Pascual-Figal D, Lage-Galle E, Blasco-Peiró T, De la Fuente-Galán L, Muñiz J. The falling incidence of hematologic cancer after heart transplantation. Clin Transplant 2014; 28:1142-7. [DOI: 10.1111/ctr.12432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - L. López
- Hospital Santa Creu i Sant Pau; Barcelona Spain
| | | | | | | | - G. Rábago
- Clínica Universidad de Navarra; Pamplona Spain
| | | | | | | | | | | | - B. Díaz-Molina
- Hospital Universitario Central de Asturias; Oviedo Spain
| | | | - E. Lage-Galle
- Hospital Universitario Virgen del Rocío; Sevilla Spain
| | | | | | - J. Muñiz
- Instituto Universitario de Ciencias de la Salud Universidad de A Coruña; A Coruña Spain
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14
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Crespo-Leiro M, Paniagua-Martín M, Gómez-Bueno M, González-Vilchez F, Lambert-Rodríguez J, Fernández-Yáñez J, Brossa Loidi V, Arizón del Prado J, Blasco Peiró T, Lage Galle E, de la Fuente Galán L, Garrido Bravo I, Almenar Bonet L, Muñiz-García J, Delgado Jiménez J. Association Between Steroids Withdrawal During the First Year After Heart Transplantation and Changes in Body Mass Index in a Two Year Follow-Up. RESTCO Study. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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15
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Crespo-Leiro M, Paniagua-Martín M, Gómez Bueno M, González-Vilchez F, Lambert-Rodríguez J, Fernández-Yáñez J, Brossa Loidi V, Lage Galle E, Arizón del Prado J, Almenar Bonet L, Blasco Peiró T, de la Fuente Galán L, Garrido Bravo I, Muñiz-García J, Delgado Jiménez J. Steroids Withdrawal During the First Year After Heart Transplantation and Its Association With Changes in Renal Function in a Two Year Follow-Up. RESTCO Study. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Crespo-Leiro M, Paniagua-Martín M, Almenar Bonet L, Alonso-Pulpón L, González-Vilchez F, Delgado-Jiménez J, Díez Villanueva P, López Granados A, Mirabet Pérez S, Manito Lorite N, Lage-Galle E, Díaz-Molina B, Rábago Juan-Aracil G, Pérez Villa F, Blasco-Peiró T, Garrido-Bravo I, de la Fuente Galán L, Muñiz-García J. The Incidence of Solid Tumours After Heart Transplantation Has Not Declined in the Last Decade. Data from the Spanish Post-Heart Transplant Tumor Registry. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Almenar L, Segovia J, Crespo-Leiro MG, Palomo J, Arizón JM, González-Vilchez F, Delgado J. Registro Español de Trasplante Cardíaco. XXIII Informe Oficial de la sección de Insuficiencia Cardíaca y Trasplante Cardíaco de la Sociedad Española de Cardiología (1984–2011). Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70030-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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18
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Crespo-Leiro MG, Villa-Arranz A, Manito-Lorite N, Paniagua-Martin MJ, Rábago G, Almenar-Bonet L, Alonso-Pulpón L, Mirabet-Pérez S, Diaz-Molina B, González-Vilchez F, Arizón de Prado JM, Romero-Rodriguez N, Delgado-Jimenez J, Roig E, Blasco-Peiró T, Pascual-Figal D, De la Fuente Galán L, Muñiz J. Lung cancer after heart transplantation: results from a large multicenter registry. Am J Transplant 2011; 11:1035-40. [PMID: 21521471 DOI: 10.1111/j.1600-6143.2011.03515.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In this study we analyzed Spanish Post-Heart-Transplant Tumour Registry data for adult heart transplantation (HT) patients since 1984. Median post-HT follow-up of 4357 patients was 6.7 years. Lung cancer (mainly squamous cell or adenocarcinoma) was diagnosed in 102 (14.0% of patients developing cancers) a mean 6.4 years post-HT. Incidence increased with age at HT from 149 per 100 000 person-years among under-45s to 542 among over-64s; was 4.6 times greater among men than women; and was four times greater among pre-HT smokers (2169 patients) than nonsmokers (2188). The incidence rates in age-at-diagnosis groups with more than one case were significantly greater than GLOBOCAN 2002 estimates for the general Spanish population, and comparison with published data on smoking and lung cancer in the general population suggests that this increase was not due to a greater prevalence of smokers or former smokers among HT patients. Curative surgery, performed in 21 of the 28 operable cases, increased Kaplan-Meier 2-year survival to 70% versus 16% among inoperable patients.
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Expósito V, Vázquez de Prada JA, Gómez-Román JJ, González-Vilchez F, Llano-Cardenal M, García-Camarero T, Fernández-Valls M, Ruano J, Martín-Durán R. Everolimus-related Pulmonary Toxicity in Heart Transplant Recipients. J Heart Lung Transplant 2008; 27:797-800. [DOI: 10.1016/j.healun.2008.03.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2007] [Revised: 02/18/2008] [Accepted: 03/27/2008] [Indexed: 11/16/2022] Open
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González-Vilchez F, Ayuela J, Ares M, Mata NS, González AG, Durán RM. Comparison of Doppler echocardiography, color M-mode Doppler, and Doppler tissue imaging for the estimation of pulmonary capillary wedge pressure. J Am Soc Echocardiogr 2002; 15:1245-50. [PMID: 12411912 DOI: 10.1067/mje.2002.125752] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To overcome the limitations of mitral inflow parameters for predicting pulmonary capillary wedge pressure (PCWP), combined indices (with Doppler tissue imaging or color M-mode Doppler) have been developed. This study was aimed to compare the accuracy of these indices to predict PCWP. Sixty-one patients were studied. The best correlations with PCWP were found for indices that combined isovolumic relaxation time with flow propagation velocity (color M-mode) or early diastolic velocity of the lateral mitral annulus (Doppler tissue). Both closely tracked changes in PCWP. The color M-mode-derived index was the most accurate in patients with normal systolic function.
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Mishra L, Vilaplana R, Singh VK, Yadaw AK, González-Vilchez F. Nitrate/nitrite reductase activity of sulfido/selenido bridged dinuclear ruthenium(III) complexes. J Inorg Biochem 2001; 86:581-5. [PMID: 11566330 DOI: 10.1016/s0162-0134(01)00218-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Series of dinuclear species [Ru(2)(L)(2)(LH)(2)-mu-S(2)Cl(2)], [Ru(2)(L)(2)(LH)(4)-mu-Se(2)Cl(2)] (L=L(1)H and L(3)H) and [Ru(2)(L(2))(2)(L(2)H)-mu-Se(2)Cl(2)].2H(2)O, where L(1)H, L(2)H and L(3)H represent for 2-mercapto-5-phenyl-1,3,4-oxadiazole, 2-mercapto-benzimidazole and 2-mercapto-benzothiazole, respectively, have been prepared and characterized by their elemental analyses and spectral (IR, UV-visible, 1H NMR and FAB mass) data. The diamagnetism of these complexes are indicative of an exchange coupled dinuclear ruthenium(III) species containing S(2)(2-) and Se(2)(2-) bridges. The complexes along with free heterocycles (L(1)H-L(3)H) as well as RuCl(3) x 3H(2)0 were tested for their nitrate and nitrite reductase activities. The electrochemical behaviour of the complexes showed irreversible oxidation peaks at +(1.04-1.40) V quite comparable to those reported for sulphido bridged complexes.
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Affiliation(s)
- L Mishra
- Department of Chemistry, Banaras Hindu University, Varanasi 221005, India
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Bernal-Méndez E, Boudvillain M, González-Vilchez F, Leng M. Chemical versatility of transplatin monofunctional adducts within multiple site-specifically platinated DNA. Biochemistry 1997; 36:7281-7. [PMID: 9200676 DOI: 10.1021/bi9703148] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The first step of the reaction between DNA and the antitumor drug cisplatin or its clinically inactive isomer transplatin yields monofunctional adducts. Most of the cisplatin monofunctional adducts further react and rather rapidly (t(1/2) smaller than a few hours) to form intrastrand and interstrand cross-links. It is generally accepted that the clinical activity of cisplatin is related to the formation of bifunctional lesions. As concerns transplatin, several studies disagree on the rate of closure of the monofunctional adducts and the nature of the bifunctional lesions. In order to explain these discrepancies, we have prepared several duplexes containing a single monofunctional trans-[Pt(NH3)2(dG)Cl]+ adduct and zero to two monofunctional [Pt(dien)(dG)]2+ adducts at defined positions. In these duplexes, the inert [Pt(dien)(dG)]2+ adducts mimic the presence of transplatin monofunctional adducts. We show that the closure of the transplatin monofunctional adducts is strongly affected by the presence of other adducts and by the length of the duplexes. These findings suggest that the discrepancies in the literature originate from the nature of the platinated samples (molar ratio of bound platinum per nucleotide, length of the DNA fragments). Our general conclusion is that within transplatin-modified DNA, at a low level of platination, the monofunctional adducts evolve slowly (t(1/2) > 24 h) into bifunctional lesions and that these bifunctional lesions are mainly interstrand cross-links. This could explain, at least in part, the clinical inefficiency of transplatin.
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Vilaplana-Serrano R, Basallote MG, Ruiz-Valero C, Gutierrez-Puebla E, González-Vilchez F. Synthesis and X-ray structural study of a novel ruthenium(III)–ethylenediaminetetraacetate complex. The first compound showing an unusual coordination site for a carboxylic (glycine) group. ACTA ACUST UNITED AC 1991. [DOI: 10.1039/c39910000100] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Vázquez de Prada JA, Martín-Duran R, García-Monco C, Calvo JR, Olalla JJ, González-Vilchez F, Gutierrez JA. Cyclosporine neurotoxicity in heart transplantation. J Heart Transplant 1990; 9:581-3. [PMID: 2231100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The neurotoxic potential of cyclosporine in previous clinical experience has not been considered a significant problem. Recently a significant incidence of severe neurotoxicity has been related to cyclosporine therapy in liver transplant recipients. In our heart transplant program we have observed an unexpectedly high incidence of serious neurologic toxicity, presumably caused by use of cyclosporine. Coma, cerebral hemorrhage, hemiparesis and dysphasia, confusion, and visual hallucinations were reported in four patients. Cyclosporine discontinuation or dose reduction eliminated the neurologic effects in all but one patient. Cyclosporine neurotoxic effects should be suspected in heart transplant recipients with central nervous system syndromes.
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Affiliation(s)
- J A Vázquez de Prada
- Servicio de Cardiología, Centro Médico Nacional Marqués de Valdecilla Santander, Spain
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