Analysis of 8-year survivors after heart transplantation: A case-control study

[ES] Introducción: Los predictores de supervivencia a largo plazo del trasplante cardiaco (TC) no han sido completamente establecidos. Pretendemos identificar los predictores de mortalidad a 8 años del TC. Métodos: De una cohorte unicéntrica prospectiva de 276 trasplantados (1991-2007), se compararon las características de los supervivientes (casos) con los fallecidos (controles) tras 8 años del TC. Se identificaron los predictores de mortalidad a 8 años mediante regresión logística multivariante. Resultados: Hubo 119 supervivientes y 157 controles. Los predictores de mortalidad a 8 años en el modelo multivariante fueron: edad del receptor (OR = 1,03; IC 95%: 1,00-1,06; p = 0,05), clase funcional (CF) IV NYHA al TC (OR = 3,57; IC 95%: 1,00-12,73; p = 0,05) y necesidad de diálisis post-TC (OR = 7,21; IC 95%: 1,41-37,02; p = 0,02). Conclusiones: La edad del receptor, CF IV NYHA al TC y la necesidad de diálisis post-TC fueron predictores independientes de mortalidad a 8 años. La infección por citomegalovirus (CMV), el desarrollo de enfermedad vascular del injerto (EVI) o hipertensión (HTA) post-TC se asociaron de forma independiente con la supervivencia a largo plazo.[EN] Introduction: Long-term survival predictors after Heart Transplantation (HT) have not been fully established. We intend to identify 8-year mortality predictors after HT. Methods: From an unicentric, prospective cohort of 276 HT patients (recruited from 1991 to 2007), characteristics of survivors (cases) vs. those who died (controls) 8 years after HT were compared. Mortality predictors were identified using a multivariate logistic regression analysis. Results: There were 119 survivors and 157 controls. 8-year mortality predictors in the multivariate model were receptor age (OR = 1.03; 95% CI: 1.00-1.06; P = .05), functional class IV NYHA at the moment of HT (OR = 3.57; 95% CI: 1.00-12.73; P = .05), and need for dialysis after HT (OR = 7.21; 95% CI: 1.41-37.02; P = .02). Conclusions: In our cohort, increased receptor age, functional class IV NYHA at the moment of HT, and need for dialysis after HT were independent predictors of 8-year mortality. Cytomegalovirus infection, development of graft vascular disease or hypertension after HT were independently associated to long-term survival

Asymptomatic and symptomatic respiratory virus infection detected in naso-pharyngeal swabs from solid organ transplant recipients early after transplantation

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