{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T07:15:59Z","timestamp":1773472559464,"version":"3.50.1"},"reference-count":9,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Among heart transplant (HT) recipients who develop advanced graft dysfunction, cardiac re\u2010transplantation may be considered. A smaller subset of patients will experience failure of their second allograft and undergo repeat re\u2010transplantation. Outcomes among these individuals are not well\u2010described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult and pediatric patients in the United Network for Organ Sharing (UNOS) registry who received HT between January 1, 1990 and December 31, 2020 were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 1990 and 2020, 90 individuals received a third HT and three underwent a fourth HT. Recipients were younger than those undergoing primary HT (mean age 32 years). Third HT was associated with significantly higher unadjusted rates of 1\u2010year mortality (18% for third HT vs. 13% for second HT vs. 9% for primary HT, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) and 10\u2010year mortality (59% for third HT vs. 42% for second HT vs. 37% for primary HT, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Mortality was highest amongst recipients aged\u00a0&gt;60 years and those re\u2010transplanted for acute graft failure. Long\u2010term rates of CAV, rejection, chronic dialysis, and hospitalization for infection were also higher.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Third HT is associated with higher morbidity and mortality than primary HT. Further consensus is needed regarding appropriate organ stewardship for this unique subgroup.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15214","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T18:50:34Z","timestamp":1702320634000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A change of heart: Characteristics and outcomes of multiple cardiac retransplant recipients"],"prefix":"10.1111","volume":"38","author":[{"given":"Jaya","family":"Batra","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0493-1326","authenticated-orcid":false,"given":"Ersilia M.","family":"DeFilippis","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8351-9219","authenticated-orcid":false,"given":"Kevin","family":"Clerkin","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Bae","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Taek","family":"Oh","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dor","family":"Lotan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veli K.","family":"Topkara","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun Hi","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhana","family":"Latif","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Colombo","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melana","family":"Yuzefpolskaya","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8561-7899","authenticated-orcid":false,"given":"Jayant","family":"Raikhelkar","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David T.","family":"Majure","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Weill Cornell Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Sayer","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Uriel","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.07.018"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.08.003"},{"key":"e_1_2_8_4_1","first-page":"996","article-title":"The International Society for Heart and Lung Transplantation (ISHLT) guidelines for the care of heart transplant recipients","volume":"33","author":"Velleca A","year":"2014","journal-title":"J Heart Lung 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