[Heart transplantation in Norway]

Area of Science:

• Cardiology
• Transplantation Medicine
• Immunology

Background:

• The Nordic countries initiated heart transplantation in 1983.
• This paper reviews the initial 16 years of heart transplantation experience at Rikshospitalet, Oslo.

Purpose of the Study:

• To present the comprehensive experience and outcomes of heart transplantation performed between 1983 and 1999.
• To analyze patient demographics, indications, immunosuppression protocols, and survival rates.

Main Methods:

• Retrospective analysis of 317 heart transplantations performed from 1983 to 1999.
• Standard triple immunosuppression regimen: ciclosporin, prednisolone, and azathioprine.
• Evaluation of early and late postoperative complications, and causes of death.

Main Results:

• A total of 317 heart transplantations were performed, averaging 23 per year.
• Recipient demographics: 82% male, mean age 47 years, 50% with coronary heart disease.
• One-year and ten-year survival rates were 85% and 53%, respectively.
• Younger recipients (<50 years) and grafts from younger donors (<35 years) correlated with significantly higher survival.
• Common early complications included acute cellular rejection and infections.
• Late mortality was primarily due to transplant-accelerated coronary heart disease and cancer.

Conclusions:

• Heart transplantation is a viable treatment option in the Nordic countries with established survival rates.
• Patient age and donor age are critical factors influencing long-term outcomes.
• Management of postoperative complications and late-term sequelae like cardiac allograft vasculopathy and malignancy is crucial.