Orthotopic Heart Transplantation: Results from the Hospital Universitario Fundación Favaloro

pp. 508-513

Abstract

Background

The favorable outcomes achieved during four decades of clinical experience have consolidated heart transplantation as the treatment of choice of refractory heart failure.

Objective

To report the outcomes of patients undergoing orthotopic heart transplantation at the Hospital Universitario Fundación Favaloro during 16 years of follow-up.

Material and Methods

A total of 335 consecutive orthotopic heart transplantations performed in 333 patients from February 1993 to December 2009 were retrospectively analyzed. Follow-up was 94%. Seven percent corresponded to pediatric heart transplantation

and 2% to heart-kidney transplantation. Thirty five percent of patients had ischemic cardiomyopathy. Transplants were elective procedures in 42% of cases (142 patients) and 58% (193 patients) were urgent/emergency procedures. Survival was analyzed using Kaplan-Meier curves.

Results

Survival rates at 1, 5, 10 and 15 years were 80%, 74%, 71% and 65%, respectively. There were no significant differences between elective and urgent/emergency procedures. Survival was also similar for the different etiologies, even in patients with Chagas cardiomyopathy. In-hospital mortality was 12.5%, with no significant differences between elective and urgent/emergency procedures. After the first year, the incidence of severe cellular rejection was < 3%. The global incidence of humoral rejection was 4.5%. Lymphoproliferative syndrome was diagnosed in 11 patients (3.5%). Twenty one percent of patients developed kidney failure, 24% diabetes mellitus, 69% hypertension and 70% dyslipemia.

Conclusion

In our center, survival rates after heart transplantation at 1, 5, 10 and 15 years were 80%, 74%, 71% and 65%, respectively.