Experience of outpatient follow-up of heart transplant recipients at Shumakov center

Heart transplantation (HT) is considered the optimal therapy for end-stage heart failure. In recent years, the number of operations performed has been growing, which has led to a rise in the number of heart transplant recipients requiring outpatient follow-up.Objective: to evaluate the effectiveness...

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Main Authors: I. I. Muminov, N. N. Koloskova, V. N. Poptsov, V. M. Zakharevich, N. P. Mozheiko, S. A. Sakhovsky, A. O. Shevchenko
Format: Article
Language:Russian
Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 2023-09-01
Series:Вестник трансплантологии и искусственных органов
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Online Access:https://journal.transpl.ru/vtio/article/view/1638
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author I. I. Muminov
N. N. Koloskova
V. N. Poptsov
V. M. Zakharevich
N. P. Mozheiko
S. A. Sakhovsky
A. O. Shevchenko
author_facet I. I. Muminov
N. N. Koloskova
V. N. Poptsov
V. M. Zakharevich
N. P. Mozheiko
S. A. Sakhovsky
A. O. Shevchenko
author_sort I. I. Muminov
collection DOAJ
description Heart transplantation (HT) is considered the optimal therapy for end-stage heart failure. In recent years, the number of operations performed has been growing, which has led to a rise in the number of heart transplant recipients requiring outpatient follow-up.Objective: to evaluate the effectiveness of the model of dual personalized follow-up of heart transplant recipients in the consultative and diagnostic department of Shumakov National Medical Research Center of Transplantology and Artificial Organs.Materials and methods. The study included 1,436 patients under outpatient follow-up from January 2008 to December 2022. Recipient data, results of laboratory and instrumental examination methods, nature and frequency of complications at different follow-up periods were analyzed.Results: At the time of discharge from the hospital, 98.7% of patients had received triple-drug immunosuppressive therapy; 6 months later, methylprednisolone was discontinued in 72.2% of recipients. Mean tacrolimus level during the 1-year follow-up was 8.7 ± 2.7 ng/mL; in the period from 1 to 5 years of followup, the mean was 5.1 ± 2.4 ng/mL. At year 1 after transplantation, 23 (1.7%) recipients had been converted to everolimus; by the end of year 5 of follow-up, the number had increased to 8.6%. The most frequently detected complications during outpatient follow-up were: hypertension (48.65%), post-transplant diabetes mellitus (7.24%), nephropathy (35.97%), and malignant neoplasms (4.2%). Recipient survival, excluding in-hospital mortality, was 96.5%; and 88.0% at year 1 and 5 of follow-up, respectively.Conclusion: The dual personalized approach model for outpatient follow-up and treatment of heart transplant recipients will improve recipient survival and quality of life in the long-term post-HT period.
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spelling doaj-art-9c82215fa16f4d52af82a1caed82b7fa2025-08-20T03:20:51ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912023-09-01253687510.15825/1995-1191-2023-3-68-751194Experience of outpatient follow-up of heart transplant recipients at Shumakov centerI. I. Muminov0N. N. Koloskova1V. N. Poptsov2V. M. Zakharevich3N. P. Mozheiko4S. A. Sakhovsky5A. O. Shevchenko6Shumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov University; Pirogov Russian National Research Medical UniversityHeart transplantation (HT) is considered the optimal therapy for end-stage heart failure. In recent years, the number of operations performed has been growing, which has led to a rise in the number of heart transplant recipients requiring outpatient follow-up.Objective: to evaluate the effectiveness of the model of dual personalized follow-up of heart transplant recipients in the consultative and diagnostic department of Shumakov National Medical Research Center of Transplantology and Artificial Organs.Materials and methods. The study included 1,436 patients under outpatient follow-up from January 2008 to December 2022. Recipient data, results of laboratory and instrumental examination methods, nature and frequency of complications at different follow-up periods were analyzed.Results: At the time of discharge from the hospital, 98.7% of patients had received triple-drug immunosuppressive therapy; 6 months later, methylprednisolone was discontinued in 72.2% of recipients. Mean tacrolimus level during the 1-year follow-up was 8.7 ± 2.7 ng/mL; in the period from 1 to 5 years of followup, the mean was 5.1 ± 2.4 ng/mL. At year 1 after transplantation, 23 (1.7%) recipients had been converted to everolimus; by the end of year 5 of follow-up, the number had increased to 8.6%. The most frequently detected complications during outpatient follow-up were: hypertension (48.65%), post-transplant diabetes mellitus (7.24%), nephropathy (35.97%), and malignant neoplasms (4.2%). Recipient survival, excluding in-hospital mortality, was 96.5%; and 88.0% at year 1 and 5 of follow-up, respectively.Conclusion: The dual personalized approach model for outpatient follow-up and treatment of heart transplant recipients will improve recipient survival and quality of life in the long-term post-HT period.https://journal.transpl.ru/vtio/article/view/1638heart transplantationvasculopathykidney failurepost-transplant diabetes mellitusmalignant neoplasmshypertension
spellingShingle I. I. Muminov
N. N. Koloskova
V. N. Poptsov
V. M. Zakharevich
N. P. Mozheiko
S. A. Sakhovsky
A. O. Shevchenko
Experience of outpatient follow-up of heart transplant recipients at Shumakov center
Вестник трансплантологии и искусственных органов
heart transplantation
vasculopathy
kidney failure
post-transplant diabetes mellitus
malignant neoplasms
hypertension
title Experience of outpatient follow-up of heart transplant recipients at Shumakov center
title_full Experience of outpatient follow-up of heart transplant recipients at Shumakov center
title_fullStr Experience of outpatient follow-up of heart transplant recipients at Shumakov center
title_full_unstemmed Experience of outpatient follow-up of heart transplant recipients at Shumakov center
title_short Experience of outpatient follow-up of heart transplant recipients at Shumakov center
title_sort experience of outpatient follow up of heart transplant recipients at shumakov center
topic heart transplantation
vasculopathy
kidney failure
post-transplant diabetes mellitus
malignant neoplasms
hypertension
url https://journal.transpl.ru/vtio/article/view/1638
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AT vmzakharevich experienceofoutpatientfollowupofhearttransplantrecipientsatshumakovcenter
AT npmozheiko experienceofoutpatientfollowupofhearttransplantrecipientsatshumakovcenter
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