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Abstract
Objective: to conduct a comparative analysis of survival rate and development of heart transplant coronary artery disease risk factors during early and late post-transplantation periods. Materials and methods: a retrospective analysis of 58 patients with was conducted in S.V. Ochapovsky Region Clinical Hospital № 1, Krasnodar. Inclusion criteria were patients with vasculopathy; group № 1 — recipients with heart transplant coronary artery disease up until 3 years after heart transplantation; group № 1 — recipients with heart transplant coronary artery desease 3 years after heart transplantation. Endomyocardial biopsy, coronary angiography and immunological examination were used for monitoring heart recipients. Results: survival rate in group № 1 — 51,9%; in group № 2 — 64,5%. During studying the influence of age category on survival rate it was discovered that belonging to the age category influences on the survival rate in group № 1, p – 0,023. Death risk in group №1 is 1,7 (0,59 – 4,85) times higher in comparison with group № 2. When combined heart transplant coronary artery desease with cellular and humoral rejection in group №1 death risk is reliably 2,75 (1,58 – 4,78) times higher (p = 0,010). The frequency of heart transplant coronary artery desease recurrence does not have a meaningful impact on the survival rate of the recipients with heart transplant coronary artery desease n both groups. One of the meaningful risk factors in two groups, which affects heart transplant coronary artery desease development is cytomegalovirus infection. Cellular rejection is also a fact which influences lethal outcome.
Highlights
Objective: to conduct a comparative analysis of survival rate and development of heart transplant coronary artery disease risk factors during early and late post-transplantation periods
During studying the influence of age category on survival rate it was discovered that belonging to the age category influences on the survival rate in group No 1, p – 0,023
Frequency of heart transplant coronary artery desease recurrence does not have a meaningful impact on the survival rate of the recipients with heart transplant coronary artery desease n both groups
Summary
Frequency of heart transplant coronary artery desease recurrence does not have a meaningful impact on the survival rate of the recipients with heart transplant coronary artery desease n both groups. Лечение эпизодов отторжения в течение первого года также является фактором риска развития васкулопатии [8,9,10]. К достижениям трансплантологии последних лет можно отнести проведение профилактических мероприятий в отношении некоторых факторов риска сердечно-сосудистых заболеваний (гиперлипидемия, ожирение, курение, сахарный диабет), повышение уровня выживаемости в течение первого года после трансплантации, прогресс в контролировании острого отторжения сердечного трансплантата, успех в профилактике и лечении цитомегаловирусной инфекции, в персонализованном подходе при подборе иммуносупрессивной терапии [4,13]. Несмотря на большое количество материалов в зарубежной и отечественной литературе, посвящённых изучению факторов риска васкулопатии, одной из важных целей трансплантологии остается снижение распространенности БКАТС в послеоперационном периоде, что приведёт к улучшению отдаленных результатов и качества жизни у реципиентов сердца. Цель исследования — провести сравнительный анализ выживаемости, оценку факторов риска с последующей стратификацией степени риска развития болезни коронарных артерий сердечного трансплантата в раннем и позднем периодах после трансплантации сердца
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