Clinical course and outcome of heart transplant recipients: single center experience at the National Cardiovascular Center in Japan.
The number of heart transplant (HTx) surgeries in Japan is expected to increase under the Revised Organ Transplant Law. To date, among 69 HTx surgeries performed in Japan, 27 operations (39.1%) were performed at our institution, the National Cardiovascular Center (NCVC), located in Osaka. We have reviewed the outcomes of HTx conducted at NCVC during a 10 year period (May 1999 to January 2009). Among 27 heart transplant recipients at NCVC, the clinical charts of 26 recipients whose post-HTx period exceeded 1 year were retrospectively reviewed and compared to data from the International Society for Heart and Lung Transplantation (ISHLT) Registry. The survival rate of our recipients was 96.2% at 10.8 years, which was excellent even compared to the ISHLT Registry. The immunosuppressive regimen at NCVC was equivalent to that of the ISHLT Registry, except for more frequent use of Muromonab-CD3 (26.9% versus 3.3%, P < 0.0001) and an initial CSA-based regimen (65.3% versus 34.4%, P < 0.001). The drug we use for induction therapy has been recently changed from Muromonab-CD3 to Basiliximab. The incidences of post-HTx hypertension, diabetes, hyperlipidemia, and renal insufficiency were significantly less in patients at NCVC compared to those in the ISHLT Registry, however, the incidence of transplant coronary artery disease (TxCAD) was almost identical. Clinical review of post-HTx outcome at NCVC can provide useful information for Japanese transplant cardiologists who will engage in HTx management.
Oda
Noboru
N
Department of Cardiovascular Medicine, National Cardiovascular Center, Osaka, Japan.
Kato
Tomoko S
TS
Komamura
Kazuo
K
Hanatani
Akihisa
A
Mano
Akiko
A
Hashimura
Kazuhiko
K
Asakura
Masanori
M
Niwaya
Kazuo
K
Funatsu
Toshihiro
T
Kobayashi
Junjiro
J
Wada
Kyoichi
K
Hashimoto
Shuji
S
Ishibashi-Ueda
Hatsue
H
Nakano
Yukiko
Y
Kihara
Yasuki
Y
Kitakaze
Masafumi
M
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control; D006331:Heart Diseases / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult