Clinical cardiac and pulmonary transplantation: the Hannover experience

Thoracic organ transplantation has evolved from an experimental to a standard treatment modality for patients suffering from end-stage heart and lung failure. Based on our experience after 1,033 heart, lung, and heart-lung transplantation procedures performed at the Hannover Thoracic Organ Transplant Program, we report: 1. Survival rates following thoracic organ transplants were similar and ranged from 76-81% after one year. 2. The one-, 5-, 10- and 15-year survival rates for heart transplant recipients were 81%, 70%, 52% and 33%, respectively. 3. The 9-year survival rate for bilateral-lung transplant recipients (56%) was significantly better than that for single-lung recipients (36%, p < 0.05). 4. Heart-lung recipients had the poorest long-term survival rate in our program--18% surviving after 9 years. 5. Retransplantation has been an effective treatment for chronic graft dysfunction in lung transplant recipients, but was less successful when used to treat acute graft failure. The one-year regraft survival rate was 74% among 15 patients retransplanted for chronic graft failure compared with only 50% for 4 patients retransplanted for acute failure.