Pre- and early postoperative risk factors for death after cardiac transplantation: A single center analysis

Due to the limited number of donor organs, death on the waiting list and wa iting time for cardiac transplantation have markedly increased. A pressing need of appropiate selection criteria for patients who would benefit most f rom transplantation is apparent. The purpose of this study is to identify p re- and early postoperative risk factors that influence long term survival after cardiac transplantation. 702 consecutive patients who underwent cardi ac transplantation between 3/1984 and 12/1997 were analyzed retrospectively for the influence of different pre- and early postoperative risk factors o n early (30 days) and late death (5 years). Univariate and multivariate reg ression analysis revealed risk factors for early as well as late death. Pre dictors of early death were higher preoperative PVR, retransplantation, lon ger ischemic time, postoperative acute kidney failure and longer intubation time. Risk factors for late death were early transplant era, previous card iac surgery, patients awaiting transplantation in a hospital, prolonged sta y in an intensive care unit, and any rejection during the first month after transplantation. These results demonstrate that pre- and early postoperati ve risk factors have significant influence on early and long term survival.