Heart Transplantation. A Retrospective Analysis of the Long-Term Results.
10.3349/ymj.2004.45.6.1173
- Author:
Suk Jung CHOO
1
;
Jae Joong KIM
;
Sang Pil KIM
;
Jun Wan LEE
;
Ryu Sang WAN
;
Nam Hee PARK
;
Sang Kwon LEE
;
Dong Gon YOO
;
Jae Won LEE
;
Hyun SONG
;
Cheol Hyun CHUNG
;
Kyung Sun KIM
;
Meong Gun SONG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Univ. of Ulsan College of Medicine, Seoul, Korea. mgsong@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Standard technique;
bicaval technique;
heart transplantation;
graft vascular disease
- MeSH:
Adult;
Female;
Follow-Up Studies;
Graft Rejection/epidemiology;
*Heart Transplantation/mortality;
Humans;
Incidence;
Kidney/blood supply;
Male;
Middle Aged;
Retrospective Studies;
Survival Analysis;
Vascular Diseases/epidemiology
- From:Yonsei Medical Journal
2004;45(6):1173-1180
- CountryRepublic of Korea
- Language:English
-
Abstract:
Long-term results of orthotopic heart transplantation vary among different institutions. The purpose of the present study was to assess the factors, which might affect long-term survival and complications. Between November 1992 and July 2003, 112 heart transplantations (M/F=89: 23) were performed. The standard technique was used in the first 57 patients and the bicaval technique in the latter 55 patients. Indications for transplantation in decreasing order of frequency were dilated cardiomyopathy (75%), ischemic cardiomyopathy (7%), and others (18%). The mean follow up duration was 51.8 +/- 31.3 months with 98 patients remaining alive. Preoperatively, all patients were either in NYHA functional class III or IV. Postoperatively, all patients showed improvement to functional class II or I, except 3 patients that remained in NYHA class III. The mean number of rejection cases within the first year was 0.6 +/- 0.8, with humoral rejection noted in 3 cases. The graft vascular disease (GVD) -free survival at 3 and 5 years was 96% and 83%, respectively. The 7-year survival after heart transplantation was 84%. There were 16 deaths, of which infection (n=4) was the most common followed by rejection (n=3), and malignancy (n=2). The present long-term results, were relatively superior to those seen in western countries. The relatively low GVD-free survival rate is thought to have contributed. The complications encountered after transplantation were mostly immunosuppressive drug related, suggesting further potentials for improvement in long-term survival.
