Incidence, risk factors, and outcomes of postoperative stroke in combined heart‐lung transplantation: A retrospective cohort study of the UNOS registry
Armaan F. Akbar, Benjamin L. Shou, Alfred J. Casillan, Ahmet Kilic, Errol L. Bush, Glenn Whitman, Sung‐Min Cho- Transplantation
Abstract
Stroke is a well‐characterized complication of isolated heart and lung transplantation, but has not been described in combined heart‐lung transplantation (HLTx). We retrospectively reviewed national U.S. data to describe the incidence, risk factors, and impact of postoperative stroke in HLTx recipients. Of 871 heart‐lung recipients between 1994–2022, 35 (4.0%) experienced stroke, and the incidence increased over time, trending toward significance (p‐trend = .07). After adjustment, extracorporeal membrane oxygenation (ECMO) (Adjusted odds ratio [aOR] = 2.63, 95%CI = [1.13–6.11]) and pre‐transplant implantable defibrillator (aOR = 2.86, 95%CI = [1.20–6.81]) were independent risk factors for stroke. Postoperative stroke is common and is increasing in an era where organ allocation is driven by mechanical circulatory support (MCS) bridging.