title: Transplantation for complex congenital heart disease in adults: a subanalysis of the Spanish Heart Transplant Registry.
abstract: BACKGROUND
  Congenital heart diseases (CHDs) have high infant mortality in their severe forms. When adulthood is reached, a heart transplant (HTx) may be required. Spanish adult population transplanted for CHD was analyzed and compared with the most frequent causes of HTx and between different subgroups of CHD.
  
  
  METHODS
  A total of 6048 patients (HTx 1984-2009) were included. Pediatric transplants (<15 yr), combined transplants, reHTx, and HTx for heart diseases other than idiopathic dilated cardiomyopathy (IDCM) and ischemic heart disease (IHD) were excluded. Total patients included: 3166 (IHD = 1888; IDCM = 1223; CHD = 55). Subgroups were studied as follows: (1) single ventricle with pulmonary stenosis (n = 18), (2) single ventricle with tricuspid atresia and Glenn/Fontan surgery (n = 10), (3) congenitally corrected transposition of the great vessels (TGV) or with switch atrial surgery (n = 10), and (4) CHD with right ventricle overload (n = 17).
  
  
  RESULTS
  Survival probability was different between groups (p = 0.0001). Post hoc analysis showed some differences between groups (CHD vs. IHD, p = 0.05; CHD vs. IDCM, p = 0.5; IHD vs. IDCM, p = 0.0001). Early mortality was different between CHD subgroups (group 1 = 19%, group 2 = 40%, group 3 = 0%, group 4 = 29%; p < 0.001); however, overall mortality did not show differences between subgroups (p = 0.5).
  
  
  CONCLUSIONS
  The percentage of Spanish adult HTx patients for CHD is low (1%). The survival curve is better than for other HTx causes (IHD). Nevertheless, early mortality was higher, particularly in some subgroups (Fontan).
authors.affiliation: Department of Cardiology, Hospital Universitario A Coruña, A Coruña, Spain. MA.Jesus.Paniagua.Martin@sergas.es
authors.forename: María J
authors.initials: MJ
authors.lastname: Paniagua Martín
authors.forename: Luis
authors.initials: L
authors.lastname: Almenar
authors.forename: Vicenç
authors.initials: V
authors.lastname: Brossa
authors.forename: Marisa G
authors.initials: MG
authors.lastname: Crespo-Leiro
authors.forename: Javier
authors.initials: J
authors.lastname: Segovia
authors.forename: Jesús
authors.initials: J
authors.lastname: Palomo
authors.forename: Juan
authors.initials: J
authors.lastname: Delgado
authors.forename: Francisco
authors.initials: F
authors.lastname: González-Vílchez
authors.forename: Nicolás
authors.initials: N
authors.lastname: Manito
authors.forename: Ernesto
authors.initials: E
authors.lastname: Lage
authors.forename: Luis
authors.initials: L
authors.lastname: García-Guereta
authors.forename: José L
authors.initials: JL
authors.lastname: Rodríguez-Lambert
authors.forename: Dimpna C
authors.initials: DC
authors.lastname: Albert
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications / Q000401:mortality* / Q000601:surgery; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012042:Registries; D015996:Survival Rate