Heart transplantation. A retrospective analysis of the long-term results.
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.
Choo
Suk Jung
SJ
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.
Kim
Jae Joong
JJ
Kim
Sang Pil
SP
Lee
Jun Wan
JW
Wan
Ryu Sang
RS
Park
Nam Hee
NH
Lee
Sang Kwon
SK
Yoo
Dong Gon
DG
Lee
Jae Won
JW
Song
Hyun
H
Chung
Cheol Hyun
CH
Kim
Kyung Sun
KS
Song
Meong Gun
MG
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