CARMEL, CALIF. — The 5-year survival rate for heart retransplant patients who have severe heart failure symptoms with preserved systolic function is about 67%, results from a single-center study showed.
“These patients have comparable survival to patients retransplanted due to systolic dysfunction and therefore should be considered candidates for retransplantation,” Lakshmi Gokanapudy said at the Western regional meeting of the American Federation for Medical Research.
Ms. Gokanapudy, an undergraduate student at the University of California, Los Angeles, and her associates in the department of medicine at the university, evaluated 31 heart transplant patients who underwent retransplantation at the university during 1994–2004. The patients mean age at time of retransplantation was 51 years, and most (75%) were male.
Of the 31 patients, 24 (77%) had severe heart failure symptoms with preserved systolic function, which was defined as having a left ventricular ejection fraction of at least 40%.
Ms. Gokanapudy reported that each of the 24 patients with preserved systolic function had shortness of breath, fatigue, and decreased exercise tolerance. Echocardiography revealed that eight (33%) had left ventricular hypertrophy.
Five of the patients (21%) had no rejection episodes, 19 (79%) had an average of 1.4 rejection episodes, and 20 (83%) developed epicardial cardiac allograft vasculopathy.
The 5-year survival rate among the 24 patients with preserved systolic function was 67%, which was similar to the 5-year survival rate among the 7 retransplanted patients in the study who had severe systolic dysfunction (57%).