Başkent Üniversitesi Yayınları

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    Gender-Based Analysis of Outcome After Heart Transplantation
    (Başkent Üniversitesi, 2012-08) Eifert, Sandra; Meiser, Bruno; Kaczmarek, Ingo; Beiras-Fernandez, Andres; Bigdeli, Amir Khosrow; Horster, Sophia; Nickel, Thomas; Kofler, Sieglinde
    Objectives: Gender differences between donors and recipients might have an effect on outcome after heart transplantation. Literature and registries reveal controversial results. We reviewed 1000 heart transplantations at our center focusing on the influence of gender differences on short- and long-term outcome after heart transplantation. Materials and Methods: We performed a retrospective analysis of 1000 (960 primary and 40 redo-heart transplantations) between August 1981 and July 2008. In contrast to other studies, the data for gender differences (donor gender and recipient gender) were evaluated for recipient survival and survival conditional to early mortality. Results: Female donors are significantly older than male donors (females, 36.5 ± 14.5 years; males, 31.2 ± 13.8 years). One-year survival was significantly inferior in male recipients receiving female donor hearts (mR/fD: 73.7%) compared to females receiving male donor organs (fR/mD: 90.9%) (P = .045). Univariate analysis revealed that, for recipients who survived > 1 year, survival at 10 years was significantly greater for female donors and female recipients (90%) than it was for male donors and male recipients (72%; P = .034). Multivariate analysis showed that the gender combination with female donors and female recipients was an independent indicator for greater long-term survival (P = .04). Conclusions: The gender combination of female donors and male recipients had a greater risk for early mortality after heart transplantation, and the combination of male donors and female recipients resulted in favorable short-term outcomes. In long-term follow-up, recipients of hearts from female donors had better survival, especially female recipients.
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    Heart Transplant in a Childhood Leukemia Survivor: A Case Report
    (Başkent Üniversitesi, 2010-03) Urbanova, Dagmar; Mladosievicova, Beata; Hrebik, Marian; Bubanska, Eva
    Objectives: Children with acute leukemia often receive therapy that is potentially cardiotoxic. Development of irreversible cardiac impairment requiring heart transplant may appear many years after anticancer therapy. Other possible causes are discussed. Material and Methods: We describe a young leukemia survivor who developed severe heart failure needing a heart transplant. Results: A 4-year-old boy was treated with standard doses of chemotherapy containing cardiotoxic daunorubicin and mitoxantrone, and later, with an allogeneic bone marrow transplant. Twelve years after the diagnosis of acute myeloid leukemia, and following a viral infection of an unknown cause, he developed symptoms of heart failure. Severe dilated cardiomyopathy; and severe, left ventricular dysfunction with ejection fraction of 12% were noted on echocardiography. The patient required a heart transplant 19 years after the diagnosis of leukemia. Conclusions: Cardiac failure may progressively occur in childhood leukemia survivors. Heart transplant is indicated in patients with refractory hemodynamic decompensation.