Long-term results of cardiac transplantation.
Heart transplantation is a successful therapeutic option for patients with end-stage heart cardiomyopathy. From April 1991 to December 2000, 345 patients underwent heart transplantation at the Juan Canalejo Hospital. The mean age of recipients was 54.5 +/- 11.4 years; 286 (83%) were male patients. Idiopathic (52.2%) and ischemic (34.9%) end-stage cardiomyopathy were the main causes leading to transplantation. Ninety-four patients had undergone a previous heart operation. The mean left ventricular ejection fraction was 22.8 +/- 11.4. Forty patients (11.5%) were transplanted in urgent (status I) condition. The mean time spent on the waiting list was 35.9 days. In-hospital mortality was 10.6% and 24% for transplantations performed on an elective and urgent basis, respectively. Operative (30-day), one-year and six-year survival was 87.2%, 81.3% and 64%, respectively. In terms of actuarial survival, there were no significant differences with regard to the recipient's age, sex, previous cardiac surgery, and the etiology of the end-stage cardiomyopathy. The six-year actuarial survival for recipients receiving hearts from female donors was 59% compared with 72% for male donors (p = 0.05). There has been a low incidence of rejection, as well as cardiac graft vasculopathy. Actuarial survival at six years was 66% for patients transplantated on an elective basis compared with 57% for patients transplanted on an urgent basis (p = 0.04). The aim of the study was to evaluate long-term results for patients who underwent orthotopic heart transplantation. In our experience, status I is associated with a higher mortality.
Juffe
Alberto
A
Division of Cardiac Surgery, Cardiac Transplant Program, Juan Canalejo Hospital, La Coruña, Spain. alberto_juffe@canalejo.org
Rodriguez
Miguel A
MA
Caputo
Enrico
E
Cuenca
Jose
J
Crespo
Marisa
M
D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006331:Heart Diseases / Q000401:mortality / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014850:Waiting Lists