La Pitié heart transplantation: 30-year single center clinical experience.
At La Pitié Hospital, 1,184 patients underwent cardiac transplantation for end-stage cardiac disease (1,122 orthotopic and 62 heterotopic) between April 1968-November 1998. Since April 1986, 140 patients have been supported using several different mechanical assist devices as a bridge to transplantation. Twenty-four retransplantations (2.2%) were performed for primary graft failure in 4 (17%), refractory acute rejection in 7(29%), coronary graft disease in 11 (46%) and others in 2 (8%) patients. In a case-control study, retransplanted patients were matched with first transplant patients and survival rates at one and 5 years were 59.4% and 38.8% compared with survival rates for retransplanted patients of 45.4% and 31.2%, respectively. Seventy-four patients survived more than 10 years (61 males, 13 females). Mortality did not increase after 10 years. Unfortunately many suffered complications: 77% had hypertension, hypercholesterolemia (22%), hyperuricemia (41%), osteoporosis (11%), osteonecrosis (5%) and diabetes (7%). Renal function remains one of the main problems; 16% had a creatinine > 180 mumol/L and patients are on chronic dialysis.
Pavie
A
A
Department of Thoracic and Cardiovascular Surgery, La Pitié Salpétrière Hospital, Paris, France.
Dorent
R
R
Reagan
M
M
Akthar
R
R
Leger
P
P
Vaissier
E
E
Levasseur
J P
JP
Bors
V
V
Gandjbakhch
I
I
D000206:Actuarial Analysis; D002410:Catholicism; D005260:Female; D006085:Graft Survival; D016027:Heart Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D016519:Hospitals, Religious / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010297:Paris; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate