[Spanish heart transplant registry. 12th official report (1984-2000)]

This paper outlines the general characteristics and results obtained with heart transplantation in Spain after including the data for the year 2000. In the course of last year 353 transplants were performed; along with the operations performed since 1984, this represents an overall total of 3445 transplants. The year 2000 was the first year in which the limit of 350 yearly operations was exceeded. The average clinical profile of the Spanish heart transplant patient corresponds to a male of about 50 years of age, with an A blood group, coronary disease that is not amenable to revascularization, and NYHA functional status IV/IV. In order to evaluate and compare this data register with others, it is important to take into account that on one hand it includes absolutely all the transplants performed in this country -thereby reliably reflecting the true situation of the technique in Spain- while on the other the analyses made are global and include high-risk transplants (urgent, recipients of advanced or paediatric age, retransplanted patients, heterotopic transplants, combined with lung, kidney and liver, etc.). The percentage of urgent heart transplants was 16%, a figure considerably lower than in previous years (20-25%). The mean early mortality in the past 10 years was 15%.Long-term survival has increased with respect to the records for last year, with a mean patient survival of 10.6 years. The probability of survival after 1, 5 and 10 years is 75, 63 and 51%, respectively. The most frequent causes of early death are infection and graft failure, while long-term survival is limited by tumors and vascular graft disease. In conclusion, we can say that our overall survival rate is slightly superior to that reported from other data records in the world literature. Nevertheless, a persisting challenge is to improve our results in the early phases of heart transplantation.