Effect of Infectious Diseases on Outcome After Heart Transplant

Van de Beek, Diederik; Kremers, Walter K.; Del Pozo, Jose L.; Daly, Richard C.; Edwards, Brooks S.; McGregor, Christopher G. A.; Robin Patel
March 2008
Mayo Clinic Proceedings;Mar2008, Vol. 83 Issue 3, p304
Academic Journal
OBJECTIVE: To determine how often cardiac allograft recipients develop infectious diseases and how the infections affect these patients. PATIENTS AND METHODS: We retrospectively studied 313 patients who underwent heart transplant at Mayo Clinic's site in Rochester, MN, from January 1, 1988, through June 30, 2006. RESULTS: In the early postoperative period (ie, period between heart transplant and discharge from the hospital), infectious diseases occurred in 70 (22%) of 313 patients but were not associated with 1-year mortality; the most commonly infected sites were the lungs (7%), bloodstream (6%), upper respiratory tract (5%), and urinary tract (4%). In the 18 years after transplant, the cumulative incidence of infectious diseases was 93%; the most common infectious complications were skin and soft tissue (63%), urinary tract (46%), cytomegalovirus (40%), lung (36%), upper respiratory tract (23%), and varicella zoster virus (15%) infections. After adjustment for baseline predictors, lung (hazard ratio [HR], 3.87; 95% confidence interval [CI], 2.49-6.02; P<.001) and central nervous system (HR, 4.48; 95% CI, 1.75-11.46; P=.002) infections were predictive of mortality. Serum creatinine levels (HR, 1.74; 95% CI, 1.07-2.81; P=.02) and sirolimus use (HR, 2.72; 95% CI, 1.00-7.36; P=.05) were predictive of lung infection. Death occurred during the study period in 95 (30%) of 313 patients, with a cumulative incidence of 71% at 18 years. The cause of death was infection in 17 (18%) of 95 patients. CONCLUSION: Early postoperative infectious complications are frequent in cardiac allograft recipients but are not associated with 1-year mortality. Lung and central nervous system infections are predictors of mortality.


Related Articles

  • Conquest of Polio.  // Time;7/20/1970, Vol. 96 Issue 3, p48 

    The article offers information on the efforts made in the U.S. to conquer poliomyelitis through mass vaccinations. It states that there have not been any case of death in the year 1969. It also states that 1969 was the first year in the history of U.S. without any polio fatality. It mentions...

  • The Impact of Neurocysticercosis in California: A Review of Hospitalized Cases. Croker, Curtis; Redelings, Matthew; Reporter, Roshan; Sorvillo, Frank; Mascola, Laurene; Wilkins, Patricia // PLoS Neglected Tropical Diseases;Jan2012, Vol. 6 Issue 1, p1 

    To assess the burden of neurocysticercosis (NCC) in California we examined statewide hospital discharge data for 2009. There were 304 cases hospitalized with NCC identified (incidence = 0.8 per 100,000). Cases were mostly Latino (84.9%), slightly more likely to be male than female (men 57.6%,...

  • Lyme neuroborreliosis. Hobson, Joyce; Weatherall, Mark W. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;6/23/2012, Vol. 344 Issue 7862, p46 

    A personal narrative is presented which explores the author's experience of Lyme neuroborreliosis, its eventual diagnosis, and its profound effect on her life. INSET: A DOCTOR'S PERSPECTIVE.

  • Acute confusion... This practice profile is based on NS723 Matata C et al (2013) Management of acute confusion in patients with CNS infections. Nursing Standard. 28, 15, 49-58. Morrow-Barnes, Abby // Nursing Standard;8/13/2014, Vol. 28 Issue 50, p61 

    A CPD article enhanced Abby Morrow-Barnes’s understanding of delirium, its many symptoms and underlying causes.

  • Nocardial brain abscess in an immunocompromised old patient: a case report and review of literature. Hailiang Tang; Tianming Mao; Ye Gong; Ying Mao; Qing Xie; Daijun Wang; Hongda Zhu; Xiancheng Chen; Liangfu Zhou // International Journal of Clinical & Experimental Medicine;2014, Vol. 7 Issue 5, p1480 

    Background: Nocardial brain abscess is a rare central nervous system (CNS) infection with high morbidity and mortality. The infection is acquired through inhalation or direct contact with the bacteria, and could spreads through blood transmission. Nocardial brain abscess is usually associated...

  • Is Polio still a concern? Amerena, Vincent // Auxiliary;Nov/Dec2007, p12 

    The article focuses in poliomyelities often called polio or infantile paralysis. Though the World Health Organization (WHO) funds an immunization program to eliminate polio globally, the disease still exists in some parts of the world. The polio virus is highly infectious and is spread from...

  • Pathophysiology of bacterial infection of the central nervous system and its putative role in the pathogenesis of behavioral changes. Barichello, Tatiana; Generoso, Jaqueline S.; Milioli, Graziele; Elias, Samuel G.; Teixeira, Antônio Lúcio // Revista Brasileira de Psiquiatria;feb2013, Vol. 35 Issue 1, p81 

    Invasion of the central nervous system (CNS) by microorganisms is a severe and frequently fatal event during the course of many infectious diseases. It may lead to deafness, blindness, cerebral palsy, hydrocephalus, cognitive impairment or permanent neurological dysfunction in survivors....

  • World faces polio dilemma. Mackenzie, Debora // New Scientist;10/6/2007, Vol. 196 Issue 2624, p12 

    The article discusses the possibility of certain strains of the polio virus to become active again as a result of a phasing out of certain vaccines for the disease. Some vaccines have used strains of the virus that are no longer found in cases, and if these vaccines are phased out, there is a...

  • Human parechovirus possible in young children with CNS infections.  // Infectious Diseases in Children;Nov2013, Vol. 26 Issue 11, p1 

    The article discusses the findings of a study by Dr. Susanna Felsenstein, published in "The Pediatric Infectious Disease Journal" which showed the possible diagnosis of human parechovirus in young children with central nervous system infection symptoms.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics