Outcomes After Heart Retransplantation: A 50-Year Single-Center Experience

ABSTRACT Objectives The objective of this study was to evaluate outcomes after heart retransplantation. Methods From January 6, 1968 to June 2019, 123 patients (112 adult and 11 pediatric patients) underwent heart retransplantation, and 2092 received primary transplantation at our institution. Propensity-score matching was used to account for baseline differences between the retransplantation and the primary transplantation only groups. Kaplan-Meier survival analyses were performed. The primary endpoint was all-cause mortality, and secondary endpoints were postoperative complications. Results Retransplantation recipient age was 39.6±16.4 years, and donor age was 26.4±11.2 years. Ninety-two recipients (74.8%) were male. Compared to recipients who only underwent primary heart transplantation, retransplantation recipients were more likely to have hypertension (44/73.3% versus 774/53.3%, p=.0022), hyperlipidemia (40/66.7% versus 447/30.7%, p Conclusions In this single-center cohort, the unadjusted long-term survival after heart retransplantation was inferior to that after primary heart transplantation, and short-term survival difference persisted after propensity-score matching. Heart retransplantation should be considered for select patients for optimal donor organ usage.