Abstract
Background: All solid organ transplantations in Norway are performed at Oslo University Hospital, Rikshospitalet. Immunosuppressive medication is given to recipients to prevent rejection. The three main problems following transplantation are rejection, infection and malignancy. The kind of immune-suppressive regimen used, its dose and duration, strongly influence both frequency and the character of infection. We have little information on infections in patients who have had a heart transplant in Norway, why this study was undertaken. Method: This is a retrospective cohort study that includes patients over the age of 18 years who was transplanted in 2005, 2010 and 2014 at Oslo University Hospital, Rikshospitalet. Patients who underwent combined transplantation of heart and another organ were excluded from the study. Data was recorded through systematic review of patient journals. Results: The most common cause of heart transplantation, the mean age and gender distribution have changed from 2005 to 2014. There is a tendency of an increasing number of female recipients, the main indication has changed from coronary heart disease to cardiomyopathy and the patients have a more complex history of multi-co-morbidity. During the first year after transplantation 44 %; 41 %; 54 % of patients had one or more rejections in 2005, 2010 and 2014, respectively. The one year mortality was reduced from 5 in 2005 to 1 in 2014. More clinical infections and microbiological pathogens was registered in the 2010- cohort. Prevalence of respiratory infections, soft tissue- and wound infections and infections in the GI-tract dominate in all cohorts. CMV was the most common pathogen the first year after transplantation in all the cohorts, but the incidence of CMV-infection was reduced from 2010 to 2014. Discussion: From 2005 to 2014 there have been an increasing number of rejections in contrast to the observed decreasing number of infections. Infections with known pathogens, particularly during the first year after transplantation, seems to be quite stable, but with a tendency of decreasing numbers of infections from 2010 to 2014. CMV was the most common pathogen in all 3 cohorts.
Background: All solid organ transplantations in Norway are performed at Oslo University Hospital, Rikshospitalet. Immunosuppressive medication is given to recipients to prevent rejection. The three main problems following transplantation are rejection, infection and malignancy. The kind of immune-suppressive regimen used, its dose and duration, strongly influence both frequency and the character of infection. We have little information on infections in patients who have had a heart transplant in Norway, why this study was undertaken. Method: This is a retrospective cohort study that includes patients over the age of 18 years who was transplanted in 2005, 2010 and 2014 at Oslo University Hospital, Rikshospitalet. Patients who underwent combined transplantation of heart and another organ were excluded from the study. Data was recorded through systematic review of patient journals. Results: The most common cause of heart transplantation, the mean age and gender distribution have changed from 2005 to 2014. There is a tendency of an increasing number of female recipients, the main indication has changed from coronary heart disease to cardiomyopathy and the patients have a more complex history of multi-co-morbidity. During the first year after transplantation 44 %; 41 %; 54 % of patients had one or more rejections in 2005, 2010 and 2014, respectively. The one year mortality was reduced from 5 in 2005 to 1 in 2014. More clinical infections and microbiological pathogens was registered in the 2010- cohort. Prevalence of respiratory infections, soft tissue- and wound infections and infections in the GI-tract dominate in all cohorts. CMV was the most common pathogen the first year after transplantation in all the cohorts, but the incidence of CMV-infection was reduced from 2010 to 2014. Discussion: From 2005 to 2014 there have been an increasing number of rejections in contrast to the observed decreasing number of infections. Infections with known pathogens, particularly during the first year after transplantation, seems to be quite stable, but with a tendency of decreasing numbers of infections from 2010 to 2014. CMV was the most common pathogen in all 3 cohorts.