Francisco González-Vílchez1, Manuel Gómez-Bueno2, Luis Almenar3, María G Crespo-Leiro4, José M Arizón5, Jesús Palomo6, Juan Delgado7, Eulalia Roig8, Ernesto Lage9, Nicolás Manito10. 1. Registro Español de Trasplante Cardiaco, Sección de Insuficiencia Cardiaca y Trasplante Cardiaco, Sociedad Española de Cardiología, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain. Electronic address: cargvf@gmail.com. 2. Servicio de Cardiología, Clínica Puerta de Hierro, Majadahonda, Madrid, Spain. 3. Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain. 4. Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain. 5. Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. 6. Servicio de Cardiología (Adultos), Hospital Universitario Gregorio Marañón, Madrid, Spain. 7. Hospital Universitario 12 de Octubre, Madrid, Spain. 8. Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, Spain. 9. Hospital Universitario Virgen del Rocío, Sevilla, Spain. 10. Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: The present article reports the characteristics and outcome of heart transplantation in Spain since it was first performed in May 1984. METHODS: We provide a descriptive analysis of the characteristics of the recipients, the donors, the surgical procedure, and results of the heart transplantations performed in Spain until 31 December 2013. RESULTS: During 2013, a total of 248 transplantation procedures were carried out, bringing the time series to a total of 7023 transplantations. The temporal analysis confirms a significant deterioration in the clinical profile of the recipients (higher percentage of older patients, severe renal failure, insulin-dependent diabetes mellitus, previous heart surgery, mechanical ventilation), of the donors (higher proportion of older donors and greater weight mismatch), and of the procedure (higher percentage of emergency transplantations which, in 2013, reached 49%, and with ischemia times > 240min). There was a marked increase in the use of circulatory assist devices prior to transplantation which, in 2013, were employed in 25.2% of all the patients. The survivals at 1, 5, 10, and 15 years were 76%, 65%, 52%, and 37%, respectively, and have remained stable since 1995. CONCLUSIONS: Heart transplantation activity in Spain remains stable in recent years, with around 250 procedures a year. Despite the clear deterioration in the clinical characteristics of the donors and recipients, and lengthening of the operative times, the results in terms of mortality continue to be comparable to those reported in our neighboring countries, and a growing use of circulatory assist devices prior to transplantation is confirmed.
INTRODUCTION AND OBJECTIVES: The present article reports the characteristics and outcome of heart transplantation in Spain since it was first performed in May 1984. METHODS: We provide a descriptive analysis of the characteristics of the recipients, the donors, the surgical procedure, and results of the heart transplantations performed in Spain until 31 December 2013. RESULTS: During 2013, a total of 248 transplantation procedures were carried out, bringing the time series to a total of 7023 transplantations. The temporal analysis confirms a significant deterioration in the clinical profile of the recipients (higher percentage of older patients, severe renal failure, insulin-dependent diabetes mellitus, previous heart surgery, mechanical ventilation), of the donors (higher proportion of older donors and greater weight mismatch), and of the procedure (higher percentage of emergency transplantations which, in 2013, reached 49%, and with ischemia times > 240min). There was a marked increase in the use of circulatory assist devices prior to transplantation which, in 2013, were employed in 25.2% of all the patients. The survivals at 1, 5, 10, and 15 years were 76%, 65%, 52%, and 37%, respectively, and have remained stable since 1995. CONCLUSIONS: Heart transplantation activity in Spain remains stable in recent years, with around 250 procedures a year. Despite the clear deterioration in the clinical characteristics of the donors and recipients, and lengthening of the operative times, the results in terms of mortality continue to be comparable to those reported in our neighboring countries, and a growing use of circulatory assist devices prior to transplantation is confirmed.
Authors: Javier de Miguel-Díez; Rodrigo Jiménez-García; Valentín Hernández-Barrera; José M de Miguel-Yanes; Manuel Méndez-Bailón; Ana López-de-Andres Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-09-26