Purpose: Heart transplantation is the standard treatment for patients with end-stage heart disease. In this study we tried to determine factors associated with rejection in heart transplant recipients.

Methods: Adults (>18 years) with no previous history of any transplantation who received a heart transplant from 2005 to 2011 and had one year follow up for the rejection were included. Data was obtained from the Organ Procurement and Transplant Network/United Network for Organ sharing. Multivariate analysis using stepwise logistic regression model was performed. Outcome includes heart graft rejection up to 1 year of follow up.

Results: Among 9701 patients who received heart transplant, 2722 had rejection during the first year of follow up. The odds ratios for the multivariate analysis are presented in Table1. Among recipient factors, age> 45 was associated with lower risk while history of hypertension and African American race was associated with a higher risk of graft rejection. Among donor factors, male gender was associated with lower risk of rejection. For transplant factors, immunosuppression with Tacrolimus and transplantation with a zero-mismatched organ was associated with lower risk while steroid therapy was accompanied by higher risk of rejection.

Conclusion: Rejection in heart transplant is still common and risk factors are similar to other solid organ transplantations.

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