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Twenty-Year Experience of Heart Transplantation: Early and Long-Term Results

  • Lee, Jae-Hong (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Yeom, Sang Yoon (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Hwang, Ho Young (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Choi, Jae-Woong (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Cho, Hyun-Jai (Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital) ;
  • Lee, Hae-Young (Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital) ;
  • Huh, Jae-Hak (Department of Thoracic and Cardiovascular Surgery, Myongji Hospital, Seonam University College of Medicine) ;
  • Kim, Ki-Bong (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital)
  • Received : 2015.08.20
  • Accepted : 2015.10.05
  • Published : 2016.08.05

Abstract

Background: We evaluated early and long-term results after heart transplantation (HTPL). Methods: One hundred five consecutive patients (male:female=80:25) who underwent HTPL between 1994 and 2013 were enrolled. Based on the changes in immunosuppressive regimen, the study patients were divided into two groups. Early and long-term clinical outcomes were evaluated and compared between the patients who underwent HTPL before (group E, n=41) and after July 2009 (group L, n=64). The group L patients were older (p<0.001), had higher incidence of hypertension (p=0.001) and chronic kidney disease (p<0.001), and more frequently needed preoperative mechanical ventilation (p=0.027) and mechanical circulatory support (p=0.014) than the group E patients. Results: Overall operative mortality was 3.8%, and postoperative morbidities included acute kidney injury (n=31), respiratory complications (n=16), reoperation for bleeding (n=15) and wound complications (n=10). There were no significant differences in early results except acute kidney injury between group E and group L patients. Overall survival rates at 1, 5, and 10 years were 83.8%, 67.7%, and 54.9%, respectively, with no significant difference between the two patient groups. Rejection-free rates at 1 and 5 years were 63.0% and 59.7%, respectively; rates were significantly higher in group L than in group E (p<0.001). Conclusion: Despite increased preoperative comorbidities, group L patients showed similar early and long-term outcomes and significantly higher rejection-free rates when compared with group E patients.

Keywords

References

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