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Paediatric heart transplantation recipients ≥7 years of age receiving donors with pre-existing coronary atherosclerosis showed progressive coronary artery disease

Part of: Advanced Imaging

Published online by Cambridge University Press:  27 September 2021

Mi Jin Kim Open the ORCID record for Mi Jin Kim [Opens in a new window] ,
Jeong Jin Yu Open the ORCID record for Jeong Jin Yu [Opens in a new window] ,
Seulgi Cha ,
Jae Suk Baek ,
Eun Seok Choi ,
Bo Sang Kwon ,
Chun Soo Park ,
Tae-Jin Yun  and
Young-Hwue Kim
Mi Jin Kim
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Jeong Jin Yu*
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Seulgi Cha
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Jae Suk Baek
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Eun Seok Choi
Affiliation:
Department of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Bo Sang Kwon
Affiliation:
Department of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Chun Soo Park
Affiliation:
Department of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Tae-Jin Yun
Affiliation:
Department of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Young-Hwue Kim
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
*
Author for correspondence: J. J. Yu, MD, Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea. Tel: +82-02-3010-3924. E-mail: jjyu@amc.seoul.kr
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Abstract

Background:

This study aimed to determine the effect of donor-transmitted atherosclerosis on the late aggravation of cardiac allograft vasculopathy in paediatric heart recipients aged ≥7 years.

Methods:

In total, 48 patients were included and 23 had donor-transmitted atherosclerosis (baseline maximal intimal thickness of >0.5 mm on intravascular ultrasonography). Logistic regression analyses were performed to identify risk factors for donor-transmitted atherosclerosis. Rates of survival free from the late aggravation of cardiac allograft vasculopathy (new or worsening cardiac allograft vasculopathy on following angiograms, starting 1 year after transplantation) in each patient group were estimated using the Kaplan–Meier method and compared using the log-rank test. The effect of the results of intravascular ultrasonography at 1 year after transplantation on the late aggravation of cardiac allograft vasculopathy, correcting for possible covariates including donor-transmitted atherosclerosis, was examined using the Cox proportional hazards model.

Results:

The mean follow-up duration after transplantation was 5.97 ± 3.58 years. The log-rank test showed that patients with donor-transmitted atherosclerosis had worse survival outcomes than those without (p = 0.008). Per the multivariate model considering the difference of maximal intimal thickness between baseline and 1 year following transplantation (hazard ratio, 22.985; 95% confidence interval, 1.948–271.250; p = 0.013), donor-transmitted atherosclerosis was a significant covariate (hazard ratio, 4.013; 95% confidence interval, 1.047–15.376; p = 0.043).

Conclusion:

Paediatric heart transplantation recipients with donor-transmitted atherosclerosis aged ≥7 years had worse late cardiac allograft vasculopathy aggravation-free survival outcomes.

Keywords

Atherosclerosiscardiac allograft vasculopathychildrenheart transplantationintravascular ultrasonography
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 7 , July 2022 , pp. 1104 - 1111
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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