title: Ege University experience in cardiac transplantation.
abstract: BACKGROUND
  End-stage heart failure can result from many cardiac and noncardiac entities that produce a poor prognosis. Medical and interventional modalities are widely used to treat this condition, although the ultimate therapy remains heart transplantation. Herein we present our clinical experience with 140 patients who underwent orthotopic heart transplantation.
  
  
  METHODS
  Between February 1998 and September 2010, we transplanted 140 patients with a mean age of 40 ± 13 years, including 109 men (77.8%) and 31 women (22%). There were 101 patients (73%) with dilated cardiomyopathy and 39 (27%) with ischemic cardiomyopathy. Two patients were retransplanted owing to graft failure. Sixteen patients on assist device support were successfully bridged to transplantation.
  
  
  RESULTS
  Eighteen patients (12.8%) died within 30 days with the most common causes being right ventricular failure (8/18, 44%) and infection (4/18, 22%). Overall mortality of 39% (55/140) was most commonly caused by infection (29%, 16/55) or right ventricular failure (20%, 11/55). Nine patients (16%) died suddenly outside of the hospital. Three patients died of rejection; 4 of graft failure, and 4 of malignant disease.
  
  
  CONCLUSIONS
  Heart transplantation remains the standard treatment modality for end-stage cardiac failure. But significant waiting list mortality rates are due to the worldwide shortage of donors. Heart transplantation in Turkey is feasible for a small and strictly selected number of patients with nonreversible congestive heart failure. In recent years, ventricular assist device applications have successful bridged subjects to transplantation, saving many patients on active waiting lists.
authors.affiliation: Department of Cardiovascular Surgery, Ege University Medical Faculty, Izmir, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ozbaran
authors.forename: T
authors.initials: T
authors.lastname: Yagdi
authors.forename: C
authors.initials: C
authors.lastname: Engin
authors.forename: S
authors.initials: S
authors.lastname: Nalbantgil
authors.forename: F
authors.initials: F
authors.lastname: Ayik
authors.forename: E
authors.initials: E
authors.lastname: Oguz
authors.forename: M
authors.initials: M
authors.lastname: Zoghi
mesh_terms: D000328:Adult; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D007166:Immunosuppressive Agents