Outpatient follow-up during the first year after heart transplantation, is it feasible?

Abstract

Introduction: First year follow-up after heart transplantation requires invasive tests. Although patients used to be hospitalized for this purpose, ambulatory invasive procedures now offer the possibility of outpatient follow-up. The feasibility and security of this strategy is unknown.

Methods: From 2007 we transitioned to outpatient follow-up. We have retrospectively reviewed the clinical course of the outpatient group (2007 to 2014) and an inpatient group (2000-2006). Basal characteristics, hospital stay, infections, rejection episodes and vascular complications were evaluated.

Results: 87 patients had Inpatient Follow-up (IF) and 98 Outpatient Follow-up (OF). Basal characteristics were similar, with significant differences in immunosuppression (tacrolimus IF 44.8% vs. OF 90.8%, and mycophenolate IF 86.2% vs OF 100%, both p values <0.001) and age (IF 52±11.5years vs. OF 56.1±11years, p=0.016). In the OF group more clinical visits were performed (IF 10 vs. OF 13, p<0.001) while hospital stay was lower (IF 23days vs. OF 3days, p<0.001). The rate of infection, rejection, and vascular complications was similar. No difference was found in 1-year mortality (IF 2.3% vs. 1.0%, p=0.60).

Conclusion: First year post-cardiac transplantation outpatient follow-up seems to be feasible and safe in terms of infection, rejection, vascular complications and mortality.

Keywords: Day hospital; Follow-up; Heart transplantation; Outpatient.