Objective:

To describe the main causes of mortality in the first 30 days post-heart transplant.

Methods:

A study was conducted on a representative patient cohort with a heart transplant performed between 2008 and 2015, and who died in the first 30 days after the procedure. The information was collected from an institutional heart transplant register. A description is presented of the sociodemographic and clinical variables, the receiver characteristics, causes of death, as well as pre-, intra-, and post-operative characteristics and complications.

Results:

A total of 74 heart transplants were performed between January 2008 and August 2015. Of these, 10 patients died in the first 30 days post-transplant (a mortality rate of 13.51%). The median age was 55 years (Inter-quartile range (IQR) 26-62 years) and 50% of them were male. The median ejection fraction pre-transplant was 24% (IQR 18-47) and time on the waiting list of 81 days (IQR 12-157 days). Four of the patients were in Stage 0 A, and the remaining 6 were in Stage 1. The median time between the transplant and death was 1 day (IQR 0-3 days, and the later mortality rate was at 18 days. The main causes of death were: multi-organ failure (5 cases), acute graft failure (3 cases), and peri-operative coagulopathy (2 cases).

Conclusions:

In an institution of reference for heart transplantation in South-West Colombia, the early post-transplant mortality rate was 13.51%, similar to that reported in international registers. The main cause of death was multi-organ failure, which occurred mainly in the first 24 hours after the heart transplant.

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