Korean J Transplant.  2022 Nov;36(Supple 1):S233. 10.4285/ATW2022.F-3752.

Postoperative outcomes and risk factors for cardiac surgery in solid organ transplant recipients

• Kim K
• Jung SH
• Yoo JS
• Kim HJ
• Kim JB
• Choo SJ
• Chung CH
• Lee JW

• KMID: 2535450
• DOI: http://doi.org/10.4285/ATW2022.F-3752

Abstract

Background
This study aimed to investigate postoperative outcomes and risk factors associated with mortality and readmission after cardiac surgery in solid organ transplant recipients.
Methods
We retrospectively analyzed 78 adult solid organ transplant recipients (58.7±10.5 years; 51 males) who consecutively underwent cardiac surgery between January 2000 and February 2022 at Asan Medical Center. Cardiac surgery included isolated coronary artery bypass grafting (CABG), isolated valve, or both CABG and valve surgical procedures. Primary outcomes included all-cause mortality and readmission.
Results
A total of 48 (61.5%) patients underwent isolated valve surgery, 21 (26.9%) patients underwent isolated CABG, and 9 (11.5%) underwent both CABG and valve surgery. Among these patients, 11 patients had valve surgery for infective endocarditis. Type of organ transplant included 43 (55.1 %) patients with kidney, 33 (42.3%) patients with liver, and 2 (2.6%) patients with lung transplants. Three (3.9%) patients had an operative (30-day) mortality. During median follow-up of 2.3 (min-max, 0.1–18.6) years, primary outcomes included death in 24 patients and readmission in 31 patients, demonstrating overall survival at 5 years of 69.4% and freedom from readmission at 5 years of 49.0%, respectively. Of note, patients with body mass index (BMI) <20 kg/m 2 demonstrated a higher mortality of 44.4% at 1 year compared to 15.1% for those with BMI ≥20 kg/m 2 . On multivariable Cox regression analysis, age and BMI were associated with all-cause mortality (hazard ratio [HR], 1.08; 95% confidence interval [CI], 1.02–1.14; P=0.008 and HR, 0.80; 95% CI, 0.67–0.96; P=0.02, respectively).
Conclusions
Cardiac surgery is feasible for solid organ transplant recipients with acceptable morbidity and mortality. Old age and low BMI were found as risk factors for worse postoperative outcomes.