Table 1.
Clinical, transplant, echocardiographic and immunosuppression characteristics of acute allograft dysfunction patients and heart transplant recipient controls at the time of diagnosis and control matching
| Variable | AAD Patients (N=10) | Controls (N=30) | p-value |
|---|---|---|---|
| Clinical and Transplant Variable | |||
| Age (years) | 53 ± 13 | 56 ± 14 | 0.24 |
| Female | 4 (40%) | 12 (40%) | 1.0 |
| Body mass index (kg/m2) | 26.4 ± 8.5 | 28.7 ± 9.2 | 0.10 |
| Heart rate (BPM) | 103 ± 16 | 87 ± 10 | <0.01 |
| Systolic blood pressure (mmHg) | 123 ± 17 | 121 ± 12 | 0.49 |
| Diastolic blood pressure (mmHg) | 75 ± 9 | 73 ± 8 | 0.68 |
| Age at transplantation (years) | 51 ± 6 | 53 ± 8 | 0.13 |
| Donor age | 35 ± 15 | 27 ± 20 | 0.04 |
| Ischemic time (minutes) | 186 ± 62 | 171 ± 73 | 0.38 |
| Heart failure etiology | 0.01 | ||
| Ischemic cardiomyopathy | 4 (40%) | 8 (27%) | |
| Dilated cardiomyopathy | 5 (50%) | 13 (43%) | |
| Hypertrophic cardiomyopathy | 1 (10%) | 2 (7%) | |
| Restrictive cardiomyopathy | 0 | 7 (7%) | |
| Congenital heart disease | 0 | 5 (16%) | |
| Dual organ transplant* | 1 (10%) | 4 (13%) | 0.35 |
| LVAD before transplant | 1 (10%) | 5 (16%) | 0.11 |
| Echocardiographic Variables | |||
| LV ejection fraction (%) | 34 ± 12 | 63 ± 8 | <0.01 |
| LV septal thickness (mm) | 11 ± 2 | 11 ± 3 | 0.76 |
| LV posterior wall thickness (mm) | 11 ± 2 | 11 ± 2 | 0.82 |
| LV end-diastolic diameter (mm) | 49 ± 7 | 46 ± 6 | 0.03 |
| LV end-systolic diameter (mm) | 41 ± 9 | 29 ± 6 | 0.01 |
| LV mass (g) | 200 ± 26 | 177 ± 18 | 0.02 |
| LV mass index (g/m2) | 101 ± 17 | 93 ± 12 | 0.12 |
| Immunosuppression Variables | |||
| Calcineurin / mTOR inhibitor | 10 (100%) | 30 (100%) | 1.0 |
| Cyclosporine | 7 (70%) | 18 (60%) | 0.19 |
| Mean dose (mg) | 325 ± 189 | 287 ± 184 | 0.02 |
| Mean trough level (ng/mL) | 213 ± 207 | 181 ± 99 | 0.04 |
| Tacrolimus | 0 | 6 (20%) | <0.01 |
| Mean dose (mg) | - | 4.6 ± 3.4 | |
| Mean trough level (ng/mL) | - | 10.3 ± 3.5 | |
| Sirolimus | 4 (40%) | 6 (20%) | 0.06 |
| Mean dose (mg) | 3.0 ± 0.6 | 2.6 ± 1.0 | 0.05 |
| Mean trough level (ng/mL) | 16.0 ± 8.9 | 10.0 ± 5.1 | 0.03 |
| Antimetabolite | 9 (90%) | 28 (93%) | 0.87 |
| Azathioprine | 3 (30%) | 9 (30%) | 1.0 |
| Mean dose (mg) | 108 ± 68 | 128 ± 63 | 0.17 |
| Mycophenolate mofetil | 6 (60%) | 19 (63%) | 0.74 |
| Mean dose (mg) | 2083 ± 585 | 1974 ± 539 | 0.02 |
| Prednisone | 7 (70%) | 22 (73%) | 0.56 |
| Mean dose (mg/kg/day) | 0.14 ± 0.07 | 0.15 ± 0.06 | 0.78 |
Data are presented as mean ±standard deviation for continuous data or as frequency (percentage) for categorical data.
*
All AAD patients and controls who underwent dual organ transplant received a heart-kidney transplant. AAD-acute allograft dysfunction, BPM-beats per minute, LV-left ventricle, LVAD-left ventricular assist device, mTOR-mammalian target of rapamycin.