Cause of death and sudden cardiac death after heart transplantation: An autopsy study

Russell T. Alexander, Charles Jr Steenbergen

Research output: Contribution to journalArticle

Abstract

Postmortem findings in 39 patients following cardiac transplantation are presented. Causes of death were right-sided heart failure after transplantation (6 [15%]), infection (5 [13%]), multisystem organ failure (4 [10%]), complications of noncardiac surgery (3 [8%]), acute rejection (3 [8%]), malignant neoplasm (3 [8%]), graft vascular disease (3 [8%]), preservation procurement injury (3 [8%]), cardiac arrhythmia (2 [5%]), other (4 [10%]), and unclear (3 [8%]). Seven patients in medically stable condition died after a sudden cardiac arrest, and these constituted 27% (7/26) of deaths more than 1 month after transplant. The 7 sudden cardiac arrests were due to graft vascular disease (2 [29%]), acute rejection (2 [29%]), cardiac arrhythmias (2 [29%]), and hyperkalemia during an exacerbation of acute renal failure (1 [14%]). In 3 of the 5 patients who died of sudden cardiac arrest not due to acute rejection, hemodialysis and plasmapheresis were triggers of the event. Pulmonary hypertensive arteriopathy was associated with early death and right-sided heart failure, and 6 of 8 patients with these changes died perioperatively or postoperatively.

Original languageEnglish (US)
Pages (from-to)740-748
Number of pages9
JournalAmerican Journal of Clinical Pathology
Volume119
Issue number5
DOIs
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

Sudden Cardiac Death
Heart Transplantation
Cause of Death
Autopsy
Transplants
Vascular Diseases
Cardiac Arrhythmias
Heart Failure
Hyperkalemia
Plasmapheresis
Acute Kidney Injury
Renal Dialysis
Transplantation
Lung
Wounds and Injuries
Infection
Neoplasms

Keywords

  • Autopsy
  • Cardiac transplantation
  • Coronary atherosclerosis
  • Fibrointimal hyperplasia
  • Rejection

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Cause of death and sudden cardiac death after heart transplantation : An autopsy study. / Alexander, Russell T.; Steenbergen, Charles Jr.

In: American Journal of Clinical Pathology, Vol. 119, No. 5, 01.05.2003, p. 740-748.

Research output: Contribution to journalArticle

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