Board Certification Review 2023 Spotlight: Cardiac Transplantation-Heart Transplant, Clinical Outcomes and Complications

Video Transcription

Video Summary

In this video, Dr. Michelle Kittleson from Cedars-Sinai in Los Angeles discusses heart transplantation outcomes and complications. She presents data from the ISHLT registry showing that survival after heart transplantation has improved over the years, with a median survival in the current era of about 12.5 years. Survival varies by indication, with patients with non-ischemic cardiomyopathy having the best survival and patients undergoing re-transplantation having the worst survival. Many factors can impact survival, including the transplant era, use of a ventricular assist device, re-transplantation, and unstable condition prior to transplant. Dr. Kittleson also discusses the quality of life after heart transplantation, with many patients having excellent physical and emotional functioning several years post-transplant. She highlights the causes of death after transplantation, including multi-organ failure, rejection, infection, cardiac allograft vasculopathy, malignancy, and renal failure. Dr. Kittleson emphasizes the importance of achieving a balance of immunosuppression in order to prevent rejection and other complications. She discusses the management of cardiac allograft vasculopathy, emphasizing the use of statins for prevention. Dr. Kittleson also discusses infection management, including prophylaxis and treatment of CMV, and the increased risk of malignancy after transplantation, particularly skin cancer and post-transplant lymphoproliferative disorder. She concludes by discussing renal dysfunction after transplantation and the need to minimize calcineurin inhibitor exposure. Overall, this video provides a comprehensive overview of heart transplantation outcomes and complications. No credits were granted in the transcript.

Meta Tag

cardiac allograft vasculopathy CAV

cardiac allograft vasculopathy statins

cardiac allograft vasculopathy CAV guidelines

cardiac allograft vasculopathy IVUS

Heart Transplant Clinical Outcomes and Complications heart transplant

Heart Transplant Clinical Outcomes and Complications immunosuppression therapy

Heart Transplant Clinical Outcomes and Complications cardiac allograft vasculopathy

infection CMV

Malignancy post-transplant

Malignancy post-transplant lymphoproliferative disorder (PTLD)

Renal Failure post-transplant

Keywords

heart transplantation

survival

complications

quality of life

immunosuppression

cardiac allograft vasculopathy

malignancy