Heart failure & cardiomyopathies
High-urgency heart transplantation and outcome trade-offs: early post-transplant infection and mortality
- retrospectively analysed
- Korea Organ Transplant Registry
- mediation, landmark, and multivariable time-dependent Cox models
+2 more
- Korea Organ Transplant Registry
- mediation, landmark, and multivariable time-dependent Cox models
Authors' conclusion
Status 0 heart transplant recipients had higher mortality and early post-transplant infection risk than Status 1-3 recipients. Early infection, largely associated with greater clinical severity and prolonged mechanical ventilation, may explain the excess mortality in this high-urgency group.
Study context
- Population
- Adult heart transplant recipients enrolled in the Korea Organ Transplant Registry (April 2014-December 2021)Status 0 287 · Status 1-3 514
- Participants
- 801 adult heart transplant recipients
- Exposure
- Status 0 vs Status 1-3 recipients
- Status 0n = 287
- Status 1-3n = 514
Main finding
As reported in the abstract
Death · 5-year follow-up
recipients died
128 (16.0%)
Observational data: associations, not effects.
Further findings
Mortality
- Mortality: P < .001
Infection, rejection and cardiac allograft vasculopathy (CAV) · 1 and 6 months
- Infection was the leading cause of death and was more frequent in Status 0 recipients at 1 and 6 months
- Infection was more frequent in Status 0 recipients at 1 and 6 months, whereas rejection and CAV rates were similar between groups
Infection as mediator of the association between urgency status and mortality · 1, 6, and 12 months
- Proportion of total effect mediated, infection at 1 month
- 47.4%
- Proportion of total effect mediated, infection at 6 months
- 34.9%
- Proportion of total effect mediated, infection at 12 months
- 34.2%
- Infection strongly associated with mortality
Determinants of infection risk
- Urgency status no longer independently associated with infection risk
- Prolonged mechanical ventilation (>24 h) remained the strongest predictor
- After adjustment for pre- and post-transplant organ support
Original publication
High-urgency heart transplantation and outcome trade-offs: early post-transplant infection and mortality. ESC Heart Fail. Published 10 June 2026. doi:10.1093/eschf/xvag167
Summarised from the published abstract; every number is checked against it