Definition:

Primary graft dysfunction (PGD) represents a major cause of early mortality following heart transplantation. Emerging evidence indicates that prolonged preoperative exposure to amiodarone may be associated with an increased risk of PGD.  In this retrospective study, we sought to assess the impact of preoperative amiodarone use on the incidence of early graft dysfunction in 100 heart transplant recipients operated between 2014 and 2024.

Method:

We performed a retrospective, single-center analysis of heart transplant recipients to evaluate the association between preoperative and perioperative risk factors and the occurrence of severe primary graft dysfunction (PGD). Patients were stratified into two groups based on preoperative amiodarone exposure: those who received amiodarone (Group 1) and those who did not (Group 2). The incidence of primary graft dysfunction (PGD) was compared between the two groups.

Results:

The amiodarone group exhibited a higher incidence of early primary graft dysfunction (PGD) compared with the group that did not receive amiodarone. 

Conclusions:

Amiodarone use preoperatively increase the risk of early PGD and consecutively risk of early death post-heart transplant. Amiodarone discontinuation and replacement with other antiarrhythmics can be the solution in high-risk patients.

Alina Cornea graduated from UMF Carol Davila in Bucharest, Romania, and relocated to Ireland in 2016. Over the years, she has been actively involved in cardiothoracic surgery research, particularly in the areas of heart and lung transplantation and mechanical circulatory support. She has recently published her research findings in several prominent medical books, including Thoracic Surgery: Cervical, Thoracic, and Abdominal Approaches (Springer, 2020, editors Nistor, Tsui et al.), New Insights in Pulmonary Hypertension (2023, chapter, editors Surani S. et al.), and Pulmonary Emphysema: Recent Updates (2024, chapter, editor Kian Chung Ong). Additionally, she co-authored a chapter in Comprehensive Interventions in End-Stage Cardiomyopathy: Mechanical Circulatory Support and Heart Transplantation(Etiology, Prevention, and Management of Cardiomyopathy, edited by Ernest A. Adeghate, May 2024). Currently, she is involved in the development of the Research Center at Beacon Academy in Dublin, Ireland. This program is designed to train students and junior doctors in medical and surgical sciences, with a special focus on pulmonary hypertension and cardiovascular diseases.