Heart Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Heart Transplant, including details on risks, prognosis, procedure, surgery, organ donation. | ||||||||
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Long-term follow-up of patients eligible, deferred, or ineligible for heart transplantation.Chiribiri A, Anselmino M, Del Grosso A, Trevi GP, Bobbio M Department of Internal Medicine-Cardiology, University of Turin, Torino, Italy. amedeo.chiribiri@unito.it BACKGROUND: When a patient is referred to a heart transplantation center, the patient and the physician should know the predicted long-term survival according to the first transplant committee decision. The aim of the study was to describe the follow-up of patients with heart failure referred to a heart transplantation center according to the initial decision to include (eligible), exclude (ineligible), or postpone (deferred) cardiac transplantation. METHODS: The study cohort consisted of 852 consecutive patients. Univariate and trend analyses were performed by classification of data into tertiles according to the date of the first visit. The Kaplan-Meier method was used to assess overall survival and probability of receiving a transplant. The Cox hazard model was used to identify predictors of survival. RESULTS: Transplantation incidence in the 3 groups (eligible, deferred, and ineligible) was 60%, 19%, and 5%, respectively. The 1-, 3-, 5-, and 10-year survival rates were 74%, 58%, 49%, and 37% among eligible patients; 87%, 72%, 62%, and 45% among deferred; and 69%, 50%, 39%, and 19% among ineligible patients (p < 0.001). The 10-year survival was 65% for eligible patients who received the transplant and 8.8% for eligible patients who did not receive the transplant. Transplantation was the most powerful predictor of survival. CONCLUSION: The initial decision identified 3 groups of patients with different survival rates. Heart transplantation increases the survival of eligible patients at a rate similar to that of less sick subjects for whom heart transplantation can be deferred. Published 31 March 2008 in J Heart Lung Transplant, 27(4): 380-6.
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