title: Heart transplantation in a low-organ-donation environment: a single center experience.
abstract: OBJECTIVE
  Heart transplantation is the "gold standard" for treating patients in end-stage heart failure who satisfy strict selection criteria. However, infrequent transplant performance, eg, less than nine per year, may be associated with suboptimal results.
  
  
  METHODS
  We reviewed our 13-year clinical experience (1996-2008) with 73 orthotopic heart transplants performed under strict selection criteria and followed closely thereafter at the only accredited center in Greece, a country with an annual rate of only seven donors per million population.
  
  
  RESULTS
  Low perioperative (5.47%) and long-term (7.5%) mortality rates were responsible for a 94% survival rate in the first year, 92% at five years, and 70% at ten years-similar to those reported worldwide-along with excellent functional recovery.
  
  
  CONCLUSIONS
  Strict recipient and donor selection criteria, combined with a rigorous multidisciplinary follow-up, yield excellent results despite the existing shortage of available grafts.
authors.affiliation: Heart and Lung Transplantation Unit, Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Gkouziouta
authors.forename: S
authors.initials: S
authors.lastname: Adamopoulos
authors.forename: A
authors.initials: A
authors.lastname: Manginas
authors.forename: G K
authors.initials: GK
authors.lastname: Karavolias
authors.forename: E
authors.initials: E
authors.lastname: Leontiadis
authors.forename: L
authors.initials: L
authors.lastname: Tsourelis
authors.forename: D
authors.initials: D
authors.lastname: Zarkalis
authors.forename: L
authors.initials: L
authors.lastname: Loukas
authors.forename: G
authors.initials: G
authors.lastname: Stavridis
authors.forename: T
authors.initials: T
authors.lastname: Antoniou
authors.forename: D
authors.initials: D
authors.lastname: Degiannis
authors.forename: E
authors.initials: E
authors.lastname: Melissari
authors.forename: L
authors.initials: L
authors.lastname: Kaklamanis
authors.forename: G
authors.initials: G
authors.lastname: Saroglou
authors.forename: P
authors.initials: P
authors.lastname: Sfirakis
authors.forename: P
authors.initials: P
authors.lastname: Alivizatos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D005260:Female; D006115:Greece; D006331:Heart Diseases / Q000145:classification / Q000601:surgery; D006333:Heart Failure / Q000601:surgery; D016027:Heart Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D012449:Safety; D015996:Survival Rate; D017741:Survivors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D055815:Young Adult