Cardiac surgery outcomes in patients with antecedent kidney, liver, and pancreas transplantation: a meta-analysis.

Cardiovascular events are among the most common causes of late death in the transplant recipient (Tx) population. Moreover, major cardiac surgical procedures are more challenging and risky due to immunosuppression and the potential impact on the transplanted organ's functional capacity. We aimed to...

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Publicado en:Reviews in Cardiovascular Medicine Vol. 21; no. 4; pp. 589 - 600
Autores principales: Bacusca, Alberto Emanuel, Enache, Mihail, Tarus, Andrei, Litcanu, Cezara Ioana, Burlacu, Alexandru, Tinica, Grigore
Formato: meta analysis research tables/charts Journal Article
Publicado: IMR Press Dec2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2020
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        10.31083/j.rcm.2020.04.192
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        atl: Cardiac surgery outcomes in patients with antecedent kidney, liver, and pancreas transplantation: a meta-analysis.
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          Bacusca, Alberto Emanuel
          Enache, Mihail
          Tarus, Andrei
          Litcanu, Cezara Ioana
          Burlacu, Alexandru
          Tinica, Grigore
        affil: Department of Cardiovascular Surgery - Cardiovascular Diseases Institute, and "Grigore T. Popa" University of Medicine, 700115, Iasi, Romania
      sug:
        subj:
          Kidney Transplantation Adverse Effects
          Liver Transplantation Adverse Effects
          Pancreas Transplantation Adverse Effects
          Cardiac Surgery Adverse Effects
          Liver Transplantation Mortality
          Postoperative Complications Mortality
          Human
          Kidney Transplantation Mortality
          Risk Factors
          Cardiac Surgery Mortality
          Treatment Outcomes
          Pancreas Transplantation Mortality
          Risk Assessment
          Female
          Postoperative Complications Etiology
          Aged
          Time Factors
          Male
          Middle Age
          Comparative Studies
          Meta Analysis
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Clinical Assessment Tools
          Impact of Events Scale
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          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Cardiovascular events are among the most common causes of late death in the transplant recipient (Tx) population. Moreover, major cardiac surgical procedures are more challenging and risky due to immunosuppression and the potential impact on the transplanted organ's functional capacity. We aimed to assess open cardiac surgery safety in abdominal solid organ transplant recipients, comparing the postoperative outcomes with those of nontransplant (N-Tx) patients. Electronic databases of PubMed, EMBASE, and SCOPUS were searched. The endpoints were: overall rate of infectious complications (wound infection, septicemia, pneumonia), cardiovascular and renal events (stroke, cardiac tamponade, acute kidney failure), 30-days, 5-years, and 10-years mortality post-cardiac surgery interventions in patients with and without prior solid organ transplantation. This meta-analysis included five studies. Higher rates of wound infection (Tx vs. N-Tx: OR: 2.03, 95% CI: 1.54 to 2.67, I2 = 0%), septicemia (OR: 3.91, 95% CI: 1.40 to 10.92, I2 = 0%), cardiac tamponade (OR: 1.83, 95% CI: 1.28 to 2.62, I2 = 0%) and kidney failure (OR: 1.70, 95 %CI: 1.44 to 2.02, I2 = 89%) in transplant recipients were reported. No significant differences in pneumonia occurrence (OR: 0.95, 95% CI: 0.71 to 1.27, I2 = 0%) stroke (OR: 0.89, 95% CI: 0.54 to 1.48, I2 = 78%) and 30-day mortality (OR: 1.92, 95% CI: 0.97 to 3.80, I2 = 0%) were observed. Surprisingly, 5-years (OR: 3.74, 95% CI: 2.54 to 5.49, I2 = 0%) and 10-years mortality rates were significantly lower in the N-Tx group (OR: 3.32, 95% CI: 2.35 to 4.69, I2 = 0%). Our study reveals that open cardiac surgery in transplant recipients is associated with worse postoperative outcomes and higher long-term mortality rates.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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