Abstract:
OBJECTIVE:To study risk factors for early and late death after heart transplantation in the current era. SUMMARY BACKGROUND DATA:The current cardiac transplant population differs from earlier periods in that an increasing number of sicker patients, such as those with ventricular assist device (LVAD) support, prior cardiac allotransplantation, and pulmonary hypertension, are undergoing transplantation. In addition, sensitized patients constitute a greater proportion of the transplanted population. Emphasis has been placed on therapies to prevent early graft loss, such as the use of nitric oxide and improved immunosuppression, in addition to newer therapies. METHODS:Five hundred thirty-six patients undergoing heart transplantation between 1993 and 1999 at a single center were evaluated (464 adults and 72 children; 109 had received prior LVAD support and 24 underwent retransplantation). The mean patient age at transplantation was 44.9 years. Logistic regression and Cox proportional hazard models were used to evaluate the following risk factors on survival: donor and recipient demographics, ischemic time, LVAD, retransplantation, pretransplant pulmonary vascular resistance, and immunologic variables (ABO, HLA matching, and pretransplant anti-HLA antibodies). RESULTS:The rate of early death (less than 30 days) was 8.5% in adults and 8.8% in children. The actuarial survival rate of the 536 patients was 83%, 77%, and 71% at 1, 3, and 5 years, respectively, by Kaplan Meier analysis. Risk factors adversely affecting survival included the year of transplant, donor age, and donor-recipient gender mismatching. Neither early nor late death was influenced by elevated pulmonary vascular resistance, sensitization, prior LVAD support, or prior cardiac allotransplantation. CONCLUSIONS:Previously identified risk factors did not adversely affect short- or long-term survival of heart transplant recipients in the current era. The steady improvement in survival during this period argues that advances in transplantation have offset the increasing acuity of transplant recipients.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
John R,Rajasinghe H,Chen JM,Weinberg AD,Sinha P,Itescu S,Lietz K,Mancini D,Oz MC,Smith CR,Rose EA,Edwards NMdoi
10.1097/00000658-200009000-00002subject
Has Abstractpub_date
2000-09-01 00:00:00pages
302-11issue
3eissn
0003-4932issn
1528-1140journal_volume
232pub_type
杂志文章abstract::Transcutaneous tissue oxygen tension (PtcO2) was evaluated as a noninvasive diagnostic test for peripheral arterial insufficiency; PtcO2 was measured at rest, during exercise, and following exercise at three leg sites in 36 controls and 138 patients with exercise-induced leg pain. Resting foot PtcO2 differed significa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198408000-00007
更新日期:1984-08-01 00:00:00
abstract::The aim of this study was to determine the long-term outcome among 390 patients with ulcerative colitis who underwent ileal J pouch-anal anastomosis and whether patient or operative factors influenced results. The combined operative morbidity rate for the pouch-anal anastomosis and the subsequent closure of the tempor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198710000-00011
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:To determine the effect of 9-cis retinoic acid (9-cis RA) on postsurgical lymphedema. BACKGROUND:9-cis RA promotes lymphangiogenesis in vitro and in vivo and has promise as a therapeutic agent to limit the development of postsurgical lymphedema. METHODS:Lymphedema was induced in the right hind limb after a ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001525
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To identify factors that have contributed to reduced rates of death and complications after esophageal resection in a 17-year period at a tertiary referral center. SUMMARY BACKGROUND DATA:There has been an evolving refinement in surgical technique and perioperative management of patients undergoing esophagea...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200103000-00006
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:Comparative effectiveness research has mostly been focused on comparison of treatment techniques. The goal of the present study was to extend the research to physician specialty. BACKGROUND:Both surgeons and interventionalists (cardiologists and radiologists) are involved in endovascular repairs (EVAR) of ao...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182a196b5
更新日期:2013-09-01 00:00:00
abstract::Early aggressive therapy with maintenance infusions of methylprednisolone sodium succinate and gentamicin sulfate significantly increases the probability for survival of baboons given LD100 Escherichia coli. The present study was designed to determine if baboons would recover when initiation of treatment was delayed u...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198107000-00009
更新日期:1981-07-01 00:00:00
abstract:OBJECTIVE:This single-institution review examined the incidence of biliary stricture formation after pancreaticoduodenectomy (PD) for benign and malignant periampullary disease. BACKGROUND:The incidence and course of stricture of the hepaticojejunostomy have not been documented after PD. METHODS:Between January 1995 ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000216285.07069.fc
更新日期:2006-05-01 00:00:00
abstract::Twenty patients with metastatic renal cell carcinoma and nine patients with minimal residual disease (MRD) but at high risk for recurrence following nephrectomy received weekly four milligram intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. Eight...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197710000-00007
更新日期:1977-10-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:High rate of complications has been reported following revascularization for acute limb ischemia (ALI). No adjuvant pharmacologic treatment, apart from anticoagulation and standard perioperative care, has been shown clinically effective. OBJECTIVE:Aim of this study was to evaluate the effects o...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000217555.49001.ca
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:Because of rising costs and shrinking reimbursements, hospitals must continually find ways to improve efficiency and productivity. This study attempts to increase caseloads in ambulatory surgery operating rooms while maintaining patient satisfaction and safety. SUMMARY BACKGROUND DATA:In most hospitals, pati...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000193600.97748.b1
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To analyze outcomes after open small-incision surgery (minilaparotomy) and laparoscopic surgery for gallstone disease in general surgical practice. METHODS:This study was a randomized, single-blind, multicenter trial comparing laparoscopic cholecystectomy (LC) to minilaparotomy cholecystectomy (MC). Both ele...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-200112000-00005
更新日期:2001-12-01 00:00:00
abstract::Conversion of jejunoileal bypass to gastric bypass was performed in 11 patients because of metabolic problems and physical discomforts, and in three patients because of insufficient weight loss. There was no mortality and little morbidity after operation. An additional mean weight loss of 6% occurred, and weight stabi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198211000-00007
更新日期:1982-11-01 00:00:00
abstract::Desmoid tumors are locally invasive, nonmetastasizing fibrous tumors most frequently seen in patients with familial polyposis coli (FPC). Of 325 patients with FPC treated at the Cleveland Clinic, 29 (8.9%) were found to have a total of 36 desmoid tumors. These tumors occur in young patients (mean age: 29.8 years), par...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198607000-00014
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:Our goal was to describe contemporary management and in-hospital mortality associated with blunt thoracic aortic intimal tears (IT) within the American College of Surgeons Trauma Quality Improvement Program. SUMMARY BACKGROUND DATA:The evidence basis for nonoperative expectant management of traumatic IT of t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004415
更新日期:2020-09-01 00:00:00
abstract::This study sought to minimize juxta-anastomotic neointimal hyperplasia (JNIH) following the use of polytetrafluorethylene (PTFE) conduits. PTFE anastomoses to canine carotid arteries (noncuff grafts) were compared with grafts with vein cuffs interposed proximally and distally between the graft and native artery. This ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198806000-00011
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Some, but not all, studies using registry data have suggested a small but significant long-term survival advantage following a curative surgical resection of gastric cancer at hospitals where the volume of such surgeries is high. However, because such data may be significantly influenced by the impact of pos...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000245469.35088.42
更新日期:2007-03-01 00:00:00
abstract::This study examines the influence of total parenteral nutrition (TPN) compared with 5% dextrose (D5) infusion on skeletal muscle and adipose tissue lipoprotein lipase (LPL) activity in nutritionally depleted, injured and infected patients. The plasma concentrations of glucose, free fatty acid (FFA), triglyceride and i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198112000-00003
更新日期:1981-12-01 00:00:00
abstract:OBJECTIVE:To identify patient characteristics associated with the development of local recurrence and the effect of local recurrence on subsequent morbidity and mortality in patients with intermediate- to high-grade extremity soft tissue sarcomas. SUMMARY BACKGROUND DATA:Numerous studies on extremity soft tissue sarco...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000048448.56448.70
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To review the literature with regard to outcome of surgical management for hilar cholangiocarcinoma (Klatskin tumor). BACKGROUND:Hilar cholangiocarcinoma is a rare tumor with a poor prognosis. Surgical resection provides the only possibility for cure. Advances in hepatobiliary imaging and surgical strategies...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3181afe0ab
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to achieve limb salvage in patients with locally advanced soft tissue sarcomas that can only be treated by amputation or functionally mutilating surgery by performing an isolated limb perfusion (ILP) with tumor necrosis factor (TNF) + melphalan (M) as induction biochemotherapy t...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/00000658-199612000-00011
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to perform an external validation of 2 institutionally derived predictive models of laparoscopic conversion in colorectal surgery using the Mayo Clinic, Rochester (MCR) laparoscopic colon and rectal surgery experience. SUMMARY OF BACKGROUND DATA:Two different predictive scoring syst...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181d355f7
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To assess what proportion of surgical malpractice claims might be prevented by the use of a surgical safety checklist. BACKGROUND:Surgical disciplines are overrepresented in the distribution of adverse events. The recently described multidisciplinary SURgical PAtient Safety System (SURPASS) checklist covers ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182068880
更新日期:2011-03-01 00:00:00
abstract::Pancreas transplantation has evolved dramatically since its introduction in 1966. As new centers for transplantation have developed, the evaluation of complications associated with pancreas transplantation has led to advances in surgical technique. Furthermore, surgical alterations of the pancreas resulting from trans...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199206000-00005
更新日期:1992-06-01 00:00:00
abstract::Thirteen patients with lymphoma of the breast are presented. In addition, 163 previously reported cases of lymphoma of the breast are reviewed. Complete staging was performed on all patients. No patient had a diagnosis of lymphoma prior to breast biopsy. The histologic findings were diffuse histiocytic lymphoma (DHL) ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198112000-00015
更新日期:1981-12-01 00:00:00
abstract:OBJECTIVE:Compare emergency general surgery (EGS) patient outcomes following index and non-index hospital readmissions, and explore predictive factors for non-index readmission. BACKGROUND:Readmission to a different hospital leads to fragmentation of care. The impact of non-index readmsision on patient outcomes follow...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004628
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:To investigate the expression of interferon regulatory factors 1 and 2 (IRF-1 and IRF-2) in human breast cancer. SUMMARY BACKGROUND DATA:Interferon regulatory factors 1 and 2 are transcription factors in the interferon gamma signal transduction pathway. IRF-1 acts as the effector arm of the interferon gamma ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200105000-00005
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:To assess the evolution of visceral transplantation in the milieu of surgical technical modifications, new immunosuppressive protocols, and other management strategies. SUMMARY BACKGROUND DATA:With the clinical feasibility of intestinal and multivisceral transplantation in 1990, multifaceted innovative tacti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b67725
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVES:Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. METHODS:Twenty...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000234932.88487.75
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To study the effects of autologous platelet-rich fibrin (PRF) versus human albumin on incisional wound breaking strength and subcutaneous collagen deposition in patients undergoing laparoscopic cholecystectomy in a randomized trial. SUMMARY BACKGROUND DATA:Platelet peptidic growth factors may stimulate colla...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181d3548c
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To assess the distant metastatic potential of duodeno-pancreatic neuroendocrine tumors (DP-NETs) in patients with MEN1, according to functional status and size. SUMMARY BACKGROUND DATA:DP-NETs, with their numerous lesions and endocrine secretion-related symptoms, continue to be a medical challenge; unfortuna...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003162
更新日期:2020-12-01 00:00:00