We can understand the concerns about ��organ wasting�� when we look at the lower survival rate for patients undergoing retransplantation as compared with first-time transplant recipients. We share the doubts about the fairness of allowing some individuals to get multiple transplants while Palbociclib research buy
others die awaiting their first. We also acknowledge that hospital expenses can be two or three times higher in the case of retransplantation. However, we do feel a commitment to patients on whom we have already performed a cardiac transplantation and who have no chance for survival other than by a salvage retransplantation. We believe that cardiac transplantation cannot be considered a ��one-time treatment option�� for all patients. In our experience, in view of the encouraging long-term survival achieved, it can clearly be justified in the case of late retransplantation in otherwise healthy recipients. In fact the difference in the actuarial survival rate was not statistically significant (P?=?0.15) when compared with that of patients undergoing primary transplantation (Fig.?1). The situation is different in case of early retransplantation for EGF (less than 1?month between the procedures): recipients selleck products
are usually very compromised, often with inotropic or ECMO support and, in our series, survival was significantly worse (P?<?0.0001). For this reason, we feel that EGF should be considered an exclusion criteria for retransplantation. Consequently, at our Institution, priority for cardiac retransplantation has been given, over the years, to the patients with transplant-related coronary artery disease. In conclusion, the overall survival rate of cardiac retransplantation is significantly lower than that of primary transplantation. This result is related to the higher perioperative mortality of patients retransplanted in early graft failure and with an interval of less than 1?month between the first and the second transplantation. Early <a href="http://www.selleck.cn/products/bmn-673.html
">Talazoparib graft failure is, in effect, an independent predictor of mortality after cardiac retransplantation and should therefore be considered an exclusion criterion, in order to avoid dissipation of resources and waste of organs. On the other hand, the long-term survival after retransplantation in patients with late graft failure is comparable with that of primary transplantation. Therefore heart retransplantation is clearly justified in the case of late rejection, on condition that rigorous selection criteria are applied. NV: study design, study performance, data collection, data analysis and paper writing. CP: study design, study performance and paper writing. MA: study design, study performance and data collection. AA: study performance and data collection. CM study performance. BC: study performance. CT: data analysis and statistical analysis. AMDA: study performance. MV: study design, study performance and paper writing. ""Abstract.