Long-term Survival Following Heart Transplantation

Objectives: The short and midterm success rates of heart transplanlation (HTx) are sufficiently well documented in the literature. However data related with long-term survival are limited. In this study, we reported our experience with adult patients who survived more than 10 yearsafter HTx. Methods: 306 adult patients were transplanred in our center between March 1983 and September 1989. 109 (36%) of them survived more than 10 years. Analysis of multiple factors is listed below. Results: The group included 94 men with 48±10 year-of age. Average survival was 12.2±1.4 y, with 91% still ali ve. Heterotopic HT was done in 7% of the patients and ı ı % were retransplanted. Patients with ischemic cardiomyopathy accounted for 4ı %, and idiopathic cardiomyopathy for 49%, with 19% UNOS (United Nations of Organ Sharing) status I patients. Pre-transplant ineidence of diabetes was 7.6%. Donor age was 2S±8 y. Patient/donor was mismatched for sex in 16.7%, race 40%, and cytomegalo virus (CMV) 43% of cases. Total HLA mismatch was 4.9±0.8 per patient. Ischemic time was 127±61 minutes. 14% of the patients underwent induction therapy with anti -lymphocyte preparation. Ineidence of rejection was 1.0±1.1 with 33.9% rejection-free. Posttransplanı CMV infection ineidence was 14.S% and total infection ineidence w as S3%. Ineidence of TxCAD w as 28.4% (31/109) in the first two years. Conclusion: HTx proves itself as a valuable form of treatment. It is obvious that with continuing advances in perioperative management and the development of more specific, less toxic immunosuppressive agents, satisfactory rates of long-term survival will be achieved.

Keywords: Heart transplantation; long-term survival; heart failure