Twenty-Year Experience of Heart Transplantation: Early and Long-Term Results.
10.5090/kjtcs.2016.49.4.242
- Author:
Jae Hong LEE
1
;
Sang Yoon YEOM
;
Ho Young HWANG
;
Jae Woong CHOI
;
Hyun Jai CHO
;
Hae Young LEE
;
Jae Hak HUH
;
Ki Bong KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Korea. kimkb@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Transplantation;
Heart;
Outcome assessment
- MeSH:
Acute Kidney Injury;
Comorbidity;
Heart Transplantation*;
Heart*;
Hemorrhage;
Humans;
Hypertension;
Incidence;
Mortality;
Renal Insufficiency, Chronic;
Reoperation;
Respiration, Artificial;
Survival Rate;
Transplantation;
Wounds and Injuries
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2016;49(4):242-249
- CountryRepublic of Korea
- Language:English
-
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.
