부산대학교 도서관

PURPOSE OF STUDY: Rejection, infection, and cardiac allograft vasculopathy remain the leading causes of post-heart transplant (HTx) mortality. However, sudden death (SD) in HTx patients (pts) is not well understood and poses a challenge in prevention. In a UNOS registry study (1987–2012), while non-SD rates improved over time, the rate of SD after HTx remained constant. We assessed incidence and potential causes of SD in HTx pts at our large single centre. METHODS USED: Between 2010–2016, we assessed 689 HTx pts, of which 110 died. Deaths were categorised into SD (n=14) and non-SD (n=96). SD was defined as pts in otherwise normal condition within 24 hours of death. We analysed causes of SD and non-SD including respiratory failure, arrhythmia, cardiac arrest, and rejection. Causes of death were determined by the care team or autopsy findings. SUMMARY OF RESULTS: 12.7% (14/110) of pts had SD. The major causes of SD were presumed arrhythmia/cardiac arrest, myocardial infarction, pulmonary embolus, and rejection. Causes of non-SD were analysed (table 1). A majority of SD pts were male (78.6%) and had both pre-HTx hypertension (57.1%) and pre-HTx coronary artery disease (57.1%). Mean recipient age was >60 years in this group. No risk factors were significant for SD by multivariate analysis. CONCLUSIONS: The incidence of SD after HTx was 12.7%. Presumed arrhythmia/cardiac arrest was the most common cause of SD. No significant risk factors were identified. The most common cause of non-SD was infection followed by rejection. Larger sample sizes are needed to confirm these findings.(Table is included in full-text article.)