Preoperative Toxoplasma gondii serostatus does not affect long-term survival of cardiac transplant recipients. Analysis of the Spanish Heart Transplantation Registry

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:250

Article

Barge-Caballero, Eduardo^1,17  Almenar-Bonet, Luis²  Crespo-Leiro, Maria G.^1,17  Brossa-Loidi, Vicens³  Rangel-Sousa, Diego⁴  Gomez-Bueno, Manuel^5,17  Farrero-Torres, Marta⁶  Diaz-Molina, Beatriz⁷  Delgado-Jimenez, Juan^8,17  Martinez-Selles, Manuel^9,17  Lopez-Granados, Amador¹⁰  De-la-Fuente-Galan, Luis¹¹  Gonzalez-Costello, Jose¹²  Garrido-Bravo, Iris P.¹³  Blasco-Peiro, Teresa¹⁴  Rabago-Juan-Aracil, Gregorio¹⁵  Gonzalez-Valchez, Francisco¹⁶ 

[1] Univ A Coruna UDC, Inst Invest Biomed A Coruna INIBIC, CHUAC, La Coruna, Spain

[2] Hosp Univ & Politecn La Fe, Valencia, Spain

[3] Hosp Santa Creu & Sant Pau, Barcelona, Spain

[4] Hosp Univ Virgen Rocio, Seville, Spain

[5] Hosp Univ Puerta Hierro, Majadahonda, Spain

[6] Hosp Clin Barcelona, Barcelona, Spain

[7] Hosp Univ Cent Asturias, Oviedo, Spain

[8] Hosp Univ Doce Octubre, Madrid, Spain

[9] Univ Europea, Univ Complutense, Hosp Univ Gregorio Maranon, Madrid, Spain

[10] Hosp Univ Reina Sofia, Cordoba, Spain

[11] Hosp Clin Univ, Valladolid, Spain

[12] Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain

[13] Hosp Univ Virgen Arrixaca, Murcia, Spain

[14] Hosp Univ Miguel Servet, Zaragoza, Spain

[15] Clin Univ Navarra, Pamplona, Spain

[16] Hosp Univ Marques de Valdecilla, Santander, Spain

[17] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Madrid, Spain

关键词: Heart transplantation;    Toxoplasma gondii;    Outcomes;    Survival;   

DOI  :  10.1016/j.ijcard.2017.09.215

来源: Elsevier

【 摘 要 】

Background: It's unclear whether pre-transplant T. gondii seropositivity is associated with impaired survival in heart transplant recipients. Objectives: To test the above-mentioned hypothesis in the Spanish Heart Transplantation Registry. Methods: Post-transplant outcomes of 4048 patients aged >16 years who underwent first, single-organ heart transplantation in 17 Spanish institutions from 1984 to 2014 were studied. Long-term post-transplant survival and survival free of cardiac death or retransplantation of 2434 (60%) T. gondii seropositive recipients and 1614 (40%) T. gondii seronegative recipients were compared. Results: T. gondii seropositive recipients were older, had higher body mass index, and presented higher prevalence of hypertension, hypercholesterolemia, COPD and Cytomegalovirus seropositivity than T. gondii seronegative recipients. In univariable analysis, pre-transplant T. gondii seropositivity was associated with increased post-transplant all-cause mortality (non-adjusted HR 1.15; 95% CI 1.04-1.26). However, this effect was no longer statistically significant after multivariable adjustment by recipient's age and sex (adjusted HR 1.01, 95% CI 0.92-1.11). Extended multivariable adjustment by other potential confounders showed similar results (adjusted HR 0.99, 95% CI 0.89-1.11). T. gondii seropositivity had no significant effect on the composite outcome cardiac death or retransplantation (non-adjusted HR 1.08, 95% CI 0.95-1.24, p = 0.235). The distribution of the causes of death was comparable in T. gondii seropositive and T. gondii seronegative recipients. No statistically significant impact of donor's T. gondii serostatus or donor-recipient T. gondii serostatus matching on post-transplant survival was observed. Conclusions: Our analysis did not show a significant independent effect of preoperative T. gondii serostatus on long-term outcomes after heart transplantation. (C) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

Free