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Reviews in Cardiovascular Medicine  2020, Vol. 21 Issue (4): 589-599     DOI: 10.31083/j.rcm.2020.04.192
Systematic Review Previous articles | Next articles
Cardiac surgery outcomes in patients with antecedent kidney, liver, and pancreas transplantation: a meta-analysis
Alberto Emanuel Bacusca1, , Mihail Enache1, , Andrei Tarus1, Cezara Ioana Litcanu1, Alexandru Burlacu2, *(), Grigore Tinica1
1Department of Cardiovascular Surgery - Cardiovascular Diseases Institute, and “Grigore T. Popa” University of Medicine, 700115, Iasi, Romania
2Department of Interventional Cardiology - Cardiovascular Diseases Institute, and “Grigore T. Popa” University of Medicine, 700115, Iasi, Romania
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Abstract:
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.
Key words:  Cardiac surgery      heart surgery      solid organ transplantation      liver transplantation      kidney transplantation      pancreas transplantation     
Submitted:  20 September 2020      Revised:  29 October 2020      Accepted:  04 November 2020      Published:  30 December 2020     
*Corresponding Author(s):  alexandru.burlacu@umfiasi.ro; alburlacu@yahoo.com (Alexandru Burlacu)   
About author:  These authors contributed equally.

Cite this article: 

Alberto Emanuel Bacusca, Mihail Enache, Andrei Tarus, Cezara Ioana Litcanu, Alexandru Burlacu, Grigore Tinica. Cardiac surgery outcomes in patients with antecedent kidney, liver, and pancreas transplantation: a meta-analysis. Reviews in Cardiovascular Medicine, 2020, 21(4): 589-599.

URL: 

https://rcm.imrpress.com/EN/10.31083/j.rcm.2020.04.192     OR     https://rcm.imrpress.com/EN/Y2020/V21/I4/589

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