Work

Characteristics and outcomes of thromboembolism following cardiac transplant: a multi-institutional retrospective study

Year: 2025

Type: article

Abstract: Background Thromboembolism (TE) is a serious and potentially life-threatening complication following orthotopic heart transplant (OHT) that is not well described in current literature. We aimed to characterize postoperative venous (VTE) and arterial thromboembolism (ATE) after OHT and describe their impact on survival. Methods We identified adult (≥ 18 years) patients undergoing OHT from 2016 to 2022 in the TriNetX Research Network, which includes data from over 140 million individuals from 102 institutions. Our primary outcomes were VTE or ATE within 30 days post-transplant and 1-year mortality. We used multivariable logistic regression to evaluate risk factors associated with TE, and the association between TE and 1-year mortality. Results Among 2625 patients from 28 institutions who underwent OHT, the 30-day incidence of TE was 34% (VTE 27%, ATE 16%) and 1-year mortality was 6%. Patients experiencing TE were older (54 vs. 52 years, p<0.001) and more likely to have comorbidities (p<0.05). Risk factors independently associated with VTE were history of hypertension, diabetes, and prior VTE; for ATE, history of diabetes, prior ATE, and prior VTE were significant (p<0.05). Risk of 1-year mortality increased with VTE (OR 1.43, p=0.045) and ATE (OR 1.82, p=0.002), but this association was not significant after adjusting for covariates (VTE: aOR 0.97, p=0.86; ATE: aOR 1.39, p=0.12). Conclusions TE is common after OHT and may reflect underlying patient comorbidity, emphasizing the need for high clinical suspicion of TE post-OHT to mitigate morbidity and mortality.

Source: Research and Practice in Thrombosis and Haemostasis

DOI: 10.1016/j.rpth.2025.103227

Authors: Alexandra A. Rizaldi, Michael B. Streiff, Ahmet Kilic, Shruti Chaturvedi

Institutions: Johns Hopkins University, Johns Hopkins Medicine

Language: English

Topic: Transplantation: Methods and Outcomes

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,250