Incidence, risk factors, and prognosis of postoperative hyperbilirubinemia after heart transplantation

Ron Bin Hsu, Fang Yue Lin, Robert J. Chen, Nai Kuan Chou, Wen Je Ko, Nai Hsin Chi, Shoei Shen Wang, Shu Hsun Chu

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: The clinical significance of postoperative hyperbilirubinemia after heart transplantation has not been reported. Here, we sought to evaluate the incidence, risk factors, and prognosis of postoperative hyperbilirubinemia after heart transplantation. Methods: Between 1987 and 2005, 256 consecutive patients undergoing heart transplantation were studied prospectively. Postoperative hyperbilirubinemia was defined as occurrence of a serum total bilirubin concentration of more than 3 mg/dl in any measurement during the postoperative period. Logistic regression was done to identify possible risk factors for postoperative hyperbilirubinemia and hospital mortality. Results: Overall incidence of postoperative hyperbilirubinemia was 57%. Among all patients, there were 35 hospital deaths (14%). In patients with postoperative hyperbilirubinemia, the mean onset time was 2.4 ± 4.4 days after transplantation and the mean peak serum total bilirubin was 10.1 ± 10.4 mg/dl. Development of postoperative hyperbilirubinemia was associated with a higher mortality (21% vs 5%, P < 0.001 by Fisher's exact test). The onset time of postoperative hyperbilirubinemia, the peak serum total bilirubin level, and the time at which the peak bilirubin level was reached were associated with hospital mortality. Old donor age, valvular heart disease, high right atrial pressure, use of mechanical ventilation before transplant, and ascites at transplant were the significant risk factors for postoperative hyperbilirubinemia. Conclusions: Postoperative hyperbilirubinemia is common in patients undergoing heart transplantation and is associated with high hospital mortality. Patients with valvular heart disease, high preoperative right atrial pressure, and ascites at transplant, who then receive an old donor heart, are at greater risk for development of postoperative hyperbilirubinemia.

Original languageEnglish
Pages (from-to)917-922
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume32
Issue number6
DOIs
Publication statusPublished - Dec 1 2007
Externally publishedYes

Fingerprint

Hyperbilirubinemia
Heart Transplantation
Incidence
Bilirubin
Hospital Mortality
Heart Valve Diseases
Atrial Pressure
Transplants
Ascites
Serum
Tissue Donors
Artificial Respiration
Postoperative Period
Transplantation
Logistic Models

Keywords

  • Heart transplantation
  • Hyperbilirubinemia

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Incidence, risk factors, and prognosis of postoperative hyperbilirubinemia after heart transplantation. / Hsu, Ron Bin; Lin, Fang Yue; Chen, Robert J.; Chou, Nai Kuan; Ko, Wen Je; Chi, Nai Hsin; Wang, Shoei Shen; Chu, Shu Hsun.

In: European Journal of Cardio-thoracic Surgery, Vol. 32, No. 6, 01.12.2007, p. 917-922.

Research output: Contribution to journalArticle

Hsu, Ron Bin ; Lin, Fang Yue ; Chen, Robert J. ; Chou, Nai Kuan ; Ko, Wen Je ; Chi, Nai Hsin ; Wang, Shoei Shen ; Chu, Shu Hsun. / Incidence, risk factors, and prognosis of postoperative hyperbilirubinemia after heart transplantation. In: European Journal of Cardio-thoracic Surgery. 2007 ; Vol. 32, No. 6. pp. 917-922.
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AU - Hsu, Ron Bin

AU - Lin, Fang Yue

AU - Chen, Robert J.

AU - Chou, Nai Kuan

AU - Ko, Wen Je

AU - Chi, Nai Hsin

AU - Wang, Shoei Shen

AU - Chu, Shu Hsun

PY - 2007/12/1

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N2 - Objective: The clinical significance of postoperative hyperbilirubinemia after heart transplantation has not been reported. Here, we sought to evaluate the incidence, risk factors, and prognosis of postoperative hyperbilirubinemia after heart transplantation. Methods: Between 1987 and 2005, 256 consecutive patients undergoing heart transplantation were studied prospectively. Postoperative hyperbilirubinemia was defined as occurrence of a serum total bilirubin concentration of more than 3 mg/dl in any measurement during the postoperative period. Logistic regression was done to identify possible risk factors for postoperative hyperbilirubinemia and hospital mortality. Results: Overall incidence of postoperative hyperbilirubinemia was 57%. Among all patients, there were 35 hospital deaths (14%). In patients with postoperative hyperbilirubinemia, the mean onset time was 2.4 ± 4.4 days after transplantation and the mean peak serum total bilirubin was 10.1 ± 10.4 mg/dl. Development of postoperative hyperbilirubinemia was associated with a higher mortality (21% vs 5%, P < 0.001 by Fisher's exact test). The onset time of postoperative hyperbilirubinemia, the peak serum total bilirubin level, and the time at which the peak bilirubin level was reached were associated with hospital mortality. Old donor age, valvular heart disease, high right atrial pressure, use of mechanical ventilation before transplant, and ascites at transplant were the significant risk factors for postoperative hyperbilirubinemia. Conclusions: Postoperative hyperbilirubinemia is common in patients undergoing heart transplantation and is associated with high hospital mortality. Patients with valvular heart disease, high preoperative right atrial pressure, and ascites at transplant, who then receive an old donor heart, are at greater risk for development of postoperative hyperbilirubinemia.

AB - Objective: The clinical significance of postoperative hyperbilirubinemia after heart transplantation has not been reported. Here, we sought to evaluate the incidence, risk factors, and prognosis of postoperative hyperbilirubinemia after heart transplantation. Methods: Between 1987 and 2005, 256 consecutive patients undergoing heart transplantation were studied prospectively. Postoperative hyperbilirubinemia was defined as occurrence of a serum total bilirubin concentration of more than 3 mg/dl in any measurement during the postoperative period. Logistic regression was done to identify possible risk factors for postoperative hyperbilirubinemia and hospital mortality. Results: Overall incidence of postoperative hyperbilirubinemia was 57%. Among all patients, there were 35 hospital deaths (14%). In patients with postoperative hyperbilirubinemia, the mean onset time was 2.4 ± 4.4 days after transplantation and the mean peak serum total bilirubin was 10.1 ± 10.4 mg/dl. Development of postoperative hyperbilirubinemia was associated with a higher mortality (21% vs 5%, P < 0.001 by Fisher's exact test). The onset time of postoperative hyperbilirubinemia, the peak serum total bilirubin level, and the time at which the peak bilirubin level was reached were associated with hospital mortality. Old donor age, valvular heart disease, high right atrial pressure, use of mechanical ventilation before transplant, and ascites at transplant were the significant risk factors for postoperative hyperbilirubinemia. Conclusions: Postoperative hyperbilirubinemia is common in patients undergoing heart transplantation and is associated with high hospital mortality. Patients with valvular heart disease, high preoperative right atrial pressure, and ascites at transplant, who then receive an old donor heart, are at greater risk for development of postoperative hyperbilirubinemia.

KW - Heart transplantation

KW - Hyperbilirubinemia

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