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• W3014384757 abstract "Purpose Heart transplantation (OHT) is now more frequently utilized across the US for management of end stage heart failure. The highest risk of mortality exists between the first 30 days and 12 months after OHT. Induction immunosuppression regimens differ among transplant centers across the U.S. The intent of our study was to identify the incidence of infection stratified by induction immunosuppressive regimen and further delineate potential risk factors that may predispose patients to infection during the first 12 months after OHT. Methods We conducted a retrospective chart review of all patients that received OHT at Mayo Clinic, FL between January 2014 and January 2019 with follow up for outcomes until October 2019. We performed parametric and non-parametric analysis as appropriate. Kaplan Meier curves and cox proportional hazards regression models were constructed to evaluate the effect of specific variables on mortality. Results 120 patients were identified within the timeframe reviewed. Average age at transplant was 54.6 years. 94 (78%) were male and 26 (22%) were female. A total of 12 (10%) patients received heart-kidney transplantation. Of the heart alone patients, 49 (41%) had left ventricular assist device (LVAD) as bridge to transplantation. 52 patients (43.3%) had infection within 1 year after OHT. Of these, 34 (65%) were bacterial, 6 (12%) viral, 3 (6%) fungal and 9 (17%) with multiple infection types. LVAD infection prior to OHT was not significantly associated with increased risk for infection after OHT (p=0.289). Induction therapy with either thymoglobulin (p=0.469) or basiliximab (p=0.655) was not significantly associated with infection after OHT. Time to weaning off prednisone was found to be the most significant (p=0.025) factor in our cohort. Infected patients remained on prednisone an average of 276 days vs 232 days for those without infection. Overall 12 month survival in our cohort was 87.5%. Conclusion Fifteen patients died within the first year. Infection related deaths occurred in 6 patients (40%). Faster taper of prednisone was associated with significantly reduced rates of infection within the first year after OHT. Limitations of this study are sample size and single center population. Further investigation for rapid prednisone taper in older individuals may decrease mortality related to infection within the first year after OHT." @default.
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• W3014384757 date "2020-04-01" @default.
• W3014384757 modified "2023-09-27" @default.
• W3014384757 title "Evaluation of Infection Risk Based on Induction Immunotherapy within the First Year after Heart Transplantation" @default.
• W3014384757 doi "https://doi.org/10.1016/j.healun.2020.01.036" @default.
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