Heart transplantation in Portugal: current status and future perspectives

Area of Science:

• Cardiology
• Transplantation Medicine
• Public Health

Background:

• Heart transplantation offers unparalleled benefits for severe heart failure patients regarding quality of life and survival.
• Portugal's heart transplant rate is significantly lower than European averages, with only 12 transplants in 1999 against an estimated need of 100.
• The country ranks 17th among 23 European nations in heart transplantation rates per capita.

Purpose of the Study:

• To analyze the structural and organizational deficiencies limiting heart transplantation in Portugal.
• To estimate the number of potential heart transplant candidates in Portugal.
• To predict the necessary resources for a successful heart transplantation program.

Main Methods:

• Analysis of existing data on heart transplantation rates in the EU and USA.
• Estimation of potential heart transplant candidates using the EPICA study.
• Resource prediction based on the natural history of severe heart failure, institutional experience, and international best practices.

Main Results:

• Key deficiencies identified include a lack of dedicated heart failure and transplant teams, inadequate infrastructure (wards, outpatient clinics), and suboptimal task distribution.
• An estimate of potential heart transplant candidates was developed.
• Resource requirements for a program serving 2 million people were projected.

Conclusions:

• Addressing structural and organizational deficits is crucial to increase heart transplantation rates in Portugal.
• Establishing dedicated teams, specialized infrastructure, and optimized task allocation are essential for program success.
• Implementing these changes will improve access to life-saving heart transplantation for Portuguese patients with severe heart failure.