[The Registry of Spanish Heart Transplantation. Eleventh official report]

As carried out since 1991, the Section of Heart Transplantation of the Spanish Cardiology Society presents an analysis of the characteristics and results of all transplants performed in Spain since the beginning of this activity (1984) up to December 31 of the year before its publication. The 336 transplants performed in 1999 in addition to all those performed since 1984 represent a total of 3,092 transplants. The number of procedures undertaken in 1998 was of 349, indicating slight decrease in transplantation activity in the last year. Nevertheless, the figures are similar and the analysis of the last years shows that the mean annual figure is close to 250 transplants/year. In our country, the mean clinical profile of the patient undergoing transplantation corresponds to a male (82%), aged 48 years (48 +/- 15), blood type A (54%) or 0 (32%), with severe heart disease due to ischemic heart disease (39%) or idiopathic dilated cardiomyopathy (35%). The recorded results have been analyzed globally, thus including all the transplants performed; high risk transplants (urgent, elderly or pediatric receptors, retransplantation, multiple heterotopic transplantation with lung, kidney and liver...) in this analysis. This should be taken into account when comparing the results with other registries. The mean early mortality (first 30 days after transplantation) corresponding to the last 10 years is of 14%. In this period, acute graft failure (35%), multi-organic failure (15%) and infections (10%) constitute the most frequent cause of death. The sum of the results obtained in 1999 and those obtained in former years show survival in the 1st, 5th and 10th year to be of 74, 62 and 47%, respectively. Global mortality is mainly due to infection (18%), acute graft failure (17%) and rejection (11%). We can conclude that, although the number of transplants performed yearly appears to have reached a plateau, the results obtained cannot be considered stable since year after year, thanks to the great experience of the Transplant Units, these results are gradually exceeding the survival levels.