Long-term Survival Following Heart Transplantation

OBJECTIVES
The short and midterm success rates of heart transplanlation (HTx) are sufficiently well documented in the literature. However data related with long-term survival are limited. In this study, we reported our experience with adult patients who survived more than 10 yearsafter HTx.
METHODS
306 adult patients were transplanred in our center between March 1983 and September 1989. 109 (36%) of them survived more than 10 years. Analysis of multiple factors is listed below.
RESULTS
The group included 94 men with 48±10 year-of age. Average survival was 12.2±1.4 y, with 91% still ali ve. Heterotopic HT was done in 7% of the patients and ı ı % were retransplanted. Patients with ischemic cardiomyopathy accounted for 4ı %, and idiopathic cardiomyopathy for 49%, with 19% UNOS (United Nations of Organ Sharing) status I patients. Pre-transplant ineidence of diabetes was 7.6%. Donor age was 2S±8 y. Patient/donor was mismatched for sex in 16.7%, race 40%, and cytomegalo virus (CMV) 43% of cases. Total HLA mismatch was 4.9±0.8 per patient. Ischemic time was 127±61 minutes. 14% of the patients underwent induction therapy with anti -lymphocyte preparation. Ineidence of rejection was 1.0±1.1 with 33.9% rejection-free. Posttransplanı CMV infection ineidence was 14.S% and total infection ineidence w as S3%. Ineidence of TxCAD w as 28.4% (31/109) in the first two years.
CONCLUSION
HTx proves itself as a valuable form of treatment. It is obvious that with continuing advances in perioperative management and the development of more specific, less toxic immunosuppressive agents, satisfactory rates of long-term survival will be achieved.