Influence of Tricuspid Regurgitation After Heart Transplantation: A Single-center Experience

Overview

Journal Transplant Direct

Publisher Wolters Kluwer

Specialty General Surgery

Date 2023 Feb 27

PMID 36845859

Authors

Rebecca Krey

Wiebke Sommer

Anna Meyer

Rasmus Rivinius

Philipp Schlegel

Norbert Frey

Matthias Karck

Gregor Warnecke

Rawa Arif

Affiliations

Soon will be listed here.

Abstract

Methods: Between January 2008 and December 2015, 169 patients underwent orthotopic heart transplantation at our center and were included in this study. TVR trends and associated clinical parameters were retrospectively analyzed. TVR was assessed after 30 d, 1 y, 3 y, and 5 y, and groups were defined according to changes in TVR grade: constant (group 1; n = 100), improvement (group 2; n = 26), and deterioration (group 3; n = 43). Survival, outcome with regard to operative technique, and long-term kidney and liver function during follow-up were assessed.

Results: Mean follow-up time was 7.67 ± 4.17 y (median 8.62, Q1 5.06, Q3 11.16). Overall mortality was 42.0%, with differences between the groups ( < 0.01). Cox regression analysis revealed improvement of TVR as a significant predictor for survival (hazard ratio 0.23; 95% confidence interval, 0.08-0.63, < 0.01). After 1 y 2.7%, after 3 y 3.7%, and after 5 y 3.9% of the patients showed persistent severe TVR. Creatinine levels after 30 d and 1, 3, and 5 y showed significant differences between the groups ( = 0.02, < 0.01, < 0.01, and = 0.01), deterioration of TVR being associated with higher creatinine levels during follow-up.

Conclusions: Deterioration of TVR is associated with higher mortality and renal dysfunction. Improvement of TVR may function as a positive predictor for long-term survival after heart transplantation. Improvement of TVR should be a therapeutic goal offering a prognostic value for long-term survival.

Citing Articles

Tricuspid regurgitation after heart transplantation: where innovation and intervention are in hibernation.

Alyaydin E, Gotschy A, Parianos D, Nagele M, Tudorache I, Flammer A Heart Fail Rev. 2025; .

PMID: 39945978 DOI: 10.1007/s10741-025-10494-2.

Tricuspid Regurgitation after Orthotopic Heart Transplantation: Trajectories and Association With Mortality.

Belani K, Brinker V, Fuller M, Cooter M, Schroder J, Mamoun N Clin Transplant. 2025; 39(1):e70062.

PMID: 39777932 PMC: 11706220. DOI: 10.1111/ctr.70062.

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