title: Is an emergency heart transplantation justified?
abstract: BACKGROUND
  Emergency heart transplantation remains an important controversy due to the shortage of donors and the previously demonstrated results inferior to other patients. These recipients display a worse clinical status and their donors are more often considered suboptimal. Nevertheless, it is the only therapeutic option for patients with advanced cardiomyopathy and acute decompensation with no response to other therapies. We compared results among the emergency indication with those of elective transplants.
  
  
  METHODS
  We analyzed the 213 patients who underwent cardiac transplantation in our center up to December 2004 to compare emergency with elective heart transplantations for preoperative and surgical variables as well as outcomes.
  
  
  RESULTS
  A higher percentage of emergency patients were New York Heart Association class IV, displayed renal dysfunction, and were women. Regarding donors, a higher percentage were over 40 years of age. No differences were observed in the early and first-year mortality or morbidity rates, although we noted a greater 5-year mortality rate among emergency cases.
  
  
  CONCLUSIONS
  In our center emergency heart transplantation was associated with only slightly worse results compared with elective transplantations. Both donors and recipients should be carefully selected to improve results.
authors.affiliation: Hospital Universitario Virgen Del Rocio, Seville, Spain. antoniogc_77@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: González
authors.forename: A
authors.initials: A
authors.lastname: Adsuar
authors.forename: A
authors.initials: A
authors.lastname: Hernández
authors.forename: J M
authors.initials: JM
authors.lastname: Borrego
authors.forename: E
authors.initials: E
authors.lastname: Gutiérrez
authors.forename: E
authors.initials: E
authors.lastname: Lage
authors.forename: R
authors.initials: R
authors.lastname: Hinojosa
authors.forename: A
authors.initials: A
authors.lastname: Ordoñez
mesh_terms: D000328:Adult; D001835:Body Weight; D004630:Emergencies; D005260:Female; D016027:Heart Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome