Introduction

1. Post-operative Complications After Orthotopic Heart Transplantation are Predictors of Long-Term Survival Balaji Krishnan, MD, MS; Srinivasan Sattiraju, MD; Ashwini Sankar, MA; Shashank Vats, MD; Kenneth Liao, MD, PhD; Ilknur Can, MD; Lin Chen, MD; Sara Shumway, MD; David G. Benditt, MD Department of Medicine, Cardiovascular Division, University of Minnesota Introduction Results • 260 OHT recipients were included (Complication group, 105 and non-Complication group, 155). • Mean follow-up was 6 years ± 302 days • Mean age at time of OHT was 52 years ± 11.7 years. • 56 total deaths - 21 cases in hospital prior to discharge. • Mean survival time • Complication group was 4years ± 209days • Non-complication group 7years ± 61days • Most common cause of death in patients • Complications - Rejection (34.62%) • Non-complication – Cardiac Arrest (33.33%). • Post-operative complications were predictors of all-cause mortality (p=0.0727), specifically • Respiratory failure (p=0.0016) • Cardiogenic shock (p=0.0018). • Preoperative variables that increased risk of mortality included • History of Coronary Artery Disease (p=0.0158) • History of Hypertension (p=0.0022). • Pre-transplant statin use attenuated risk of early mortality (p=0.0459). The aim of this study was to assess if complications in the post-operative period after orthotopic heart transplantation (OHT) were predictive of long-term survival. We hypothesized that post-operative complications would confer an increased risk of long-term mortality. Methods Cox Multivariate Models for Prediction of Long-Term Survival • Study Participants: Patients who underwent OHT between 1997 and 2007 at the University of Minnesota • Post-operative complications: defined as any complication that occurred between the transplant surgery and first hospital discharge. • Redo-sternotomy Acute renal failure • Rejection of allograft RV failure • Any infection Cardiogenic shock • Respiratory failure  Pneumothorax • Statistical Analysis:Multivariate logistic regression was used to model each early post-operative hospital complication in relation to mortality, adjusting for the following covariates of the receipient.. • Covariates: Indication for transplant • PretranplantComorbidties • Post-tranplantComorbidities • Operative Report Conclusion All cause Post-operative complications, specifically Cardiogenic Shock and Respiratory Failure, were predictors of mortality in patients who had orthotopic heart transplantation surgery. Pre-transplant history of CAD and HTN conferred an increased risk of mortality, Pre-transplant statin use attenuated risk of mortality after OHT. Kaplan Meier Curve for All-cause Hospital Complication mortality Kaplan Meier Curve for Respiratory Failure Kaplan Meier Curve for Cardiogenic Shock