title: Heart transplantation. A retrospective analysis of the long-term results.
abstract: Long-term results of orthotopic heart transplantation vary among different institutions. The purpose of the present study was to assess the factors, which might affect long-term survival and complications. Between November 1992 and July 2003, 112 heart transplantations (M/F=89:23) were performed. The standard technique was used in the first 57 patients and the bicaval technique in the latter 55 patients. Indications for transplantation in decreasing order of frequency were dilated cardiomyopathy (75%), ischemic cardiomyopathy (7%), and others (18%). The mean follow up duration was 51.8 +/- 31.3 months with 98 patients remaining alive. Preoperatively, all patients were either in NYHA functional class III or IV. Postoperatively, all patients showed improvement to functional class II or I, except 3 patients that remained in NYHA class III. The mean number of rejection cases within the first year was 0.6 +/- 0.8, with humoral rejection noted in 3 cases. The graft vascular disease (GVD)-free survival at 3 and 5 years was 96% and 83%, respectively. The 7-year survival after heart transplantation was 84%. There were 16 deaths, of which infection (n=4) was the most common followed by rejection (n=3), and malignancy (n=2). The present long-term results, were relatively superior to those seen in western countries. The relatively low GVD-free survival rate is thought to have contributed. The complications encountered after transplantation were mostly immunosuppressive drug related, suggesting further potentials for improvement in long-term survival.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138- 736, Korea.
authors.forename: Suk Jung
authors.initials: SJ
authors.lastname: Choo
authors.forename: Jae Joong
authors.initials: JJ
authors.lastname: Kim
authors.forename: Sang Pil
authors.initials: SP
authors.lastname: Kim
authors.forename: Jun Wan
authors.initials: JW
authors.lastname: Lee
authors.forename: Ryu Sang
authors.initials: RS
authors.lastname: Wan
authors.forename: Nam Hee
authors.initials: NH
authors.lastname: Park
authors.forename: Sang Kwon
authors.initials: SK
authors.lastname: Lee
authors.forename: Dong Gon
authors.initials: DG
authors.lastname: Yoo
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Hyun
authors.initials: H
authors.lastname: Song
authors.forename: Cheol Hyun
authors.initials: CH
authors.lastname: Chung
authors.forename: Kyung Sun
authors.initials: KS
authors.lastname: Kim
authors.forename: Meong Gun
authors.initials: MG
authors.lastname: Song
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D016027:Heart Transplantation / Q000401:mortality; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D014652:Vascular Diseases / Q000453:epidemiology