Incidence of Deep Venous Thrombosis and its Impact on Outcomes after Heart Transplantation

Abstract

<h3>Purpose</h3> We sought to characterize deep vein thrombosis (DVT) in heart transplant recipients and describe its impact on clinical outcomes. <h3>Methods</h3> Adult (≧ 18 years) patients undergoing heart transplantation from 2015 to 2018 at our center were retrospectively reviewed. Re-transplantation and combined transplantation were excluded from the analysis. Post-transplant DVT was defined as newly diagnosed venous system thrombus by imaging studies. <h3>Results</h3> There were 173 patients. The median age of cohort was 56 years, and 27% were female. A total of 29 (16.7%) patients were diagnosed with DVT, including 1 (0.5%) with lower extremity DVT, 1 (0.5%) with right atrium, and 27 (16.1%) with upper extremity DVT. The median time to diagnosis was 11 days. One patient developed pulmonary embolism 29 day after transplant. The cumulative incidence of DVT was 19.6 % at 30-days (Figure 1). Thrombosis was associated with longer hospital stay (21 days vs 26 days, p=0.012. However, there was no difference in one-year survival between groups (non-DVT 93.0% vs, DVT 92.9%, log-rank p=0.988) (Figure 2). On the univariable logistic regression analysis, posttransplant extracorporeal membrane oxygenation usage was associated with an increased risk of DVT during hospital stay (OR 4.134, 95% CI 1.729-9.888, p=0.001). <h3>Conclusion</h3> DVT after heart transplant is common and significantly increased the length of hospital stay. Appropriate preventive measures, and post-diagnostic treatment strategies are warranted.