Predictors of mortality following heart transplantation: Spanish Registry of Heart Transplantation 1984-2003.
BACKGROUND
Because the number of heart transplants performed per center is rather low, multicenter registries and databases are designed to analyze a large number of transplants to draw reliable conclusions. The objective of this study was to determine the factors associated with early and late mortality following heart transplantation.


METHODS
All heart transplants performed in Spain since the start of activity (May 1984) to December 31, 2001 were analyzed. Using multivariate methods with Cox regression. The variables included donor, recipient, immunosuppression, surgical and follow-up factors (a total of 111 variables).


RESULTS
The Total number of transplants was 4386. Early survival (at 30 days posttransplant) was 86%; survivals at 1, 5, and 10 years were 76%, 66%, and 54%, respectively. Variables associated with early mortality were acute graft failure, ventricular assistance, prior surgery, urgent transplant, bypass duration >180 minutes, and combined transplant. Variables associated with late mortality were acute graft failure, renal dysfunction, obesity, CMV+ serology, absence of induction therapy, infection, dialysis, and neurologic complications.


CONCLUSIONS
Multicenter records of large databases are essential to draw reliable conclusions. This Registry provided reliable information on heart transplants in our country. The identification of factors associated with mortality provides a good perspective on the problems and a basis for future solutions and prospective studies.
Bonet
L A
LA
Department of Cardiology, La Fe University Hospital, Valencia, Spain. lu.almenarb5@comv.es
D006331:Heart Diseases / Q000145:classification / Q000601:surgery; D016027:Heart Transplantation / Q000276:immunology / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007239:Infections / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D017211:Treatment Failure
D007166:Immunosuppressive Agents