Results of heart transplantation: 18 years experience in University Hospital Dubrava, Zagreb

Background

Despite advances in medical treatment, development of new surgical procedures and the availability of mechanical circulatory support heart transplantation (HTx) remains the treatment of choice for end-stage heart failure. Objective of this study is to report single center experience and outcomes of patients undergoing HTx.

Methods

We retrospectively examined the outcomes from ninety-five HTx recipients between September 1995 and May 2013. The mean recipient age was 55±8 years, and 85% were male. Dilated cardiomyopathy was present in 40%, ischemic in 30% and 30% were other causes. Ten patients (10%) that were heart recipients from our cohort were on high urgent list of Eurotransplant. As an induction of immunosuppressive therapy we were using antithymocyte globulin, and for maintenance a combination of cyclosporine, prednisone and mycophenolate. Survival was studied using Kaplan-Meier curves.

Results

In-hospital mortality was 12%. The median follow-up was 20 months. The global survival rates at 1, 5, and 10 years were 82%, 77%, and 62% respectively. The mean survival is 105 months (95% CI, 93.4-118.3). Early main causes of death were sepsis (41%) and primary graft failure (29%) and late causes were late rejection (20%), malignant disease and other causes (10%).

Conclusion

In our center, post-HTx survival rates at 1, 5, and 10 years were even better than those reported by the International Society of Heart and Lung Transplantation as a result of combined effort of all medical personnel involved in perioperative and postoperative management.