BACKGROUND: Heart transplantation is no longer considered an experimental operation, but rather a standard treatment; nevertheless the context has changed substantially in recent years owing to donor shortage. The aim of this study was to review the heart transplant experience focusing on very long-term survival (≥ 20 years) and to compare the initial results with the current era. METHODS: From April 1983 through April 1995, 156 consecutive patients underwent heart transplantation. Patients who survived 20 years or longer (group 1) were compared with patients who died within 20 years after surgery (group 2). To compare patient characteristics with the current era, we evaluated our recent 5-year experience (group 3; patients who underwent transplantation between 2010 and 2015), focusing on differences in terms of donor and recipient characteristics. RESULTS: Group 1 (n = 46, 30%) included younger patients (38 ± 11 v. 48 ± 8 yr, p = 0.001), a higher proportion of female recipients (28% v. 8%, p = 0.001) and a lower prevalence of ischemic heart disease (42% v. 65%, p = 0.001) than group 2 (n = 110, 70%). Patients in group 3 (n = 54) were older (52 ± 12 v. 38 ± 11 yr, p = 0.001), sicker (rate of hospital admission at transplantation 48% v. 20%, p = 0.001) and transplanted with organs from older donors (42 ± 15 v. 29 ± 11 yr, p = 0.001) than those in group 1. CONCLUSION: Very long-term survival ( ≥ 20 yr) was observed in 30% of patients transplanted during the first decade of our experience. This outcome will be difficult to duplicate in the current era considering our present population of older and sicker patients transplanted with organs from older donors.
BACKGROUND: Heart transplantation is no longer considered an experimental operation, but rather a standard treatment; nevertheless the context has changed substantially in recent years owing to donor shortage. The aim of this study was to review the heart transplant experience focusing on very long-term survival (≥ 20 years) and to compare the initial results with the current era. METHODS: From April 1983 through April 1995, 156 consecutive patients underwent heart transplantation. Patients who survived 20 years or longer (group 1) were compared with patients who died within 20 years after surgery (group 2). To compare patient characteristics with the current era, we evaluated our recent 5-year experience (group 3; patients who underwent transplantation between 2010 and 2015), focusing on differences in terms of donor and recipient characteristics. RESULTS: Group 1 (n = 46, 30%) included younger patients (38 ± 11 v. 48 ± 8 yr, p = 0.001), a higher proportion of female recipients (28% v. 8%, p = 0.001) and a lower prevalence of ischemic heart disease (42% v. 65%, p = 0.001) than group 2 (n = 110, 70%). Patients in group 3 (n = 54) were older (52 ± 12 v. 38 ± 11 yr, p = 0.001), sicker (rate of hospital admission at transplantation 48% v. 20%, p = 0.001) and transplanted with organs from older donors (42 ± 15 v. 29 ± 11 yr, p = 0.001) than those in group 1. CONCLUSION: Very long-term survival ( ≥ 20 yr) was observed in 30% of patients transplanted during the first decade of our experience. This outcome will be difficult to duplicate in the current era considering our present population of older and sicker patients transplanted with organs from older donors.
Authors: Marshall I Hertz; David O Taylor; Elbert P Trulock; Mark M Boucek; Paul J Mohacsi; Leah B Edwards; Berkeley M Keck Journal: J Heart Lung Transplant Date: 2002-09 Impact factor: 10.247
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Authors: J A Kobashigawa; L W Miller; S D Russell; G A Ewald; M J Zucker; L R Goldberg; H J Eisen; K Salm; D Tolzman; J Gao; W Fitzsimmons; R First Journal: Am J Transplant Date: 2006-06 Impact factor: 8.086
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Authors: T C Merigan; D G Renlund; S Keay; M R Bristow; V Starnes; J B O'Connell; S Resta; D Dunn; P Gamberg; R M Ratkovec Journal: N Engl J Med Date: 1992-04-30 Impact factor: 91.245
Authors: T Deuse; F Haddad; M Pham; S Hunt; H Valantine; M J Bates; H R Mallidi; P E Oyer; R C Robbins; B A Reitz Journal: Am J Transplant Date: 2008-06-12 Impact factor: 8.086
Authors: Aya Saito; Richard J Novick; Bob Kiaii; F Neil McKenzie; Mackenzie Quantz; Peter Pflugfelder; Grant Fisher; Michael W A Chu Journal: Can J Surg Date: 2013-02 Impact factor: 2.089
Authors: Sebastian V Rojas; Murat Avsar; Fabio Ius; David Schibilsky; Tim Kaufeld; Christoph Benk; Ilona Maeding; Michael Berchtold-Herz; Christoph Bara; Friedhelm Beyersdorf; Axel Haverich; Gregor Warnecke; Matthias Siepe Journal: Life (Basel) Date: 2022-02-07