Post‐transplant inotrope score is associated with clinical outcomes after adult heart transplantation. Issue 8 (22nd May 2021)

• Record Type: Journal Article
• Authors: Venema, Constantijn S.; Erasmus, Michiel E.; Mariani, Massimo; Voors, Adriaan A.; Damman, Kevin
• Is Part Of: Clinical transplantation. Volume 35:Issue 8(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-05-22
• Subjects: assist device -- continuous veno‐venous hemofiltration -- heart transplantation -- inotropic agents -- ischemia time -- mechanical circulatory support -- primary graft dysfunction -- urea -- vasopressors; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.14347
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: Inotrope score has been proposed as a marker of clinical outcome after adult heart transplantation (HTx) but is rarely used in practice. Methods: Inotrope score during the first 48 h after HTx was calculated in 81 patients as: dopamine + dobutamine + amrinone + milrinone (dose × 15) + epinephrine (dose × 100) + norepinephrine (dose × 100) + enoximone + isoprenaline (dose × 100), with each drug in µg/kg/min. Determinants of inotrope score were identified with linear regression. Cox regression was used to determine the association of inotrope score with mortality. Results: The mean recipient age was 52 ± 11 years, and 32 (39.5%) patients were female. Determinants of inotrope score were preoperative C‐reactive protein, serum urea, congenital heart disease, and donor cardiac arrest ( R 2 = .30). Inotrope score was associated with 5‐year mortality, independent of recipient age and gender (HR 1.03, 95% CI 1.00‐1.07). This association was attenuated when adjusting for female‐to‐male transplant and ischemia time. Inotrope score was also strongly associated with continuous veno‐venous hemofiltration (OR 1.07, 95% CI 1.03‐1.12). Conclusion: High inotrope score post‐HTx was observed in recipient congenital heart disease and was associated with a higher risk of mortality and acute kidney injury.