Cardiac surgery outcomes in patients with antecedent kidney, liver, and pancreas transplantation: a meta-analysis

Reviews in Cardiovascular Medicine

Alberto Emanuel Bacusca¹  Andrei Tarus¹  Grigore Tinica¹  Mihail Enache¹  Cezara Ioana Litcanu¹  Alexandru Burlacu² 

[1] Department of Cardiovascular Surgery - Cardiovascular Diseases Institute, and “Grigore T. Popa” University of Medicine, 700115, Iasi, Romania;Department of Interventional Cardiology - Cardiovascular Diseases Institute, and “Grigore T. Popa” University of Medicine, 700115, Iasi, Romania;

关键词: cardiac surgery;    heart surgery;    solid organ transplantation;    liver transplantation;    kidney transplantation;    pancreas transplantation;   

DOI  :  10.31083/j.rcm.2020.04.192

来源: DOAJ

【 摘 要 】

Cardiovascular events are among the most common causes of late death in the transplant recipient (Tx) population. Moreover, major cardiac surgical procedures are more challenging and risky due to immunosuppression and the potential impact on the transplanted organ's functional capacity. We aimed to assess open cardiac surgery safety in abdominal solid organ transplant recipients, comparing the postoperative outcomes with those of nontransplant (N-Tx) patients. Electronic databases of PubMed, EMBASE, and SCOPUS were searched. The endpoints were: overall rate of infectious complications (wound infection, septicemia, pneumonia), cardiovascular and renal events (stroke, cardiac tamponade, acute kidney failure), 30-days, 5-years, and 10-years mortality post-cardiac surgery interventions in patients with and without prior solid organ transplantation. This meta-analysis included five studies. Higher rates of wound infection (Tx vs. N-Tx: OR: 2.03, 95% CI: 1.54 to 2.67, I2 = 0%), septicemia (OR: 3.91, 95% CI: 1.40 to 10.92, I2 = 0%), cardiac tamponade (OR: 1.83, 95% CI: 1.28 to 2.62, I2 = 0%) and kidney failure (OR: 1.70, 95% CI: 1.44 to 2.02, I2 = 89%) in transplant recipients were reported. No significant differences in pneumonia occurrence (OR: 0.95, 95% CI: 0.71 to 1.27, I2 = 0%) stroke (OR: 0.89, 95% CI: 0.54 to 1.48, I2 = 78%) and 30-day mortality (OR: 1.92, 95% CI: 0.97 to 3.80, I2 = 0%) were observed. Surprisingly, 5-years (OR: 3.74, 95% CI: 2.54 to 5.49, I2 = 0%) and 10-years mortality rates were significantly lower in the N-Tx group (OR: 3.32, 95% CI: 2.35 to 4.69, I2 = 0%). Our study reveals that open cardiac surgery in transplant recipients is associated with worse postoperative outcomes and higher long-term mortality rates.

【 授权许可】

Unknown