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[Heart transplantation].

Norihide Fukushima1, Hikaru Matsuda

  • 1Department of Surgery, Osaka University Graduate School of Medicine.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|November 10, 2005
PubMed
Summary

Despite strict laws limiting heart transplantation (HTx) in Japan, 27 patients received the procedure. Most recipients were discharged, with many returning to work or school, showing HTx

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Area of Science:

  • Cardiovascular Surgery
  • Transplantation Medicine
  • Immunosuppression Therapy

Background:

  • Global heart transplantation (HTx) volume is high, but Japan's strict Organ Transplantation Law limits procedures.
  • Since 1999, only 27 HTx cases have been performed in Japan under stringent regulations.
  • Previous HTx in Japan utilized triple immunosuppressive regimens.

Purpose of the Study:

  • To review the outcomes of heart transplantation in Japan.
  • To discuss advancements and future directions in Japanese HTx.
  • To analyze the impact of immunosuppression and assist devices on HTx success.

Main Methods:

  • Retrospective analysis of 27 heart transplantation cases performed in Japan since February 1999.
  • Review of immunosuppressive regimens, including triple therapy and novel agents.
  • Discussion of pre-transplant conditioning for presensitized patients and use of ventricular assist devices.

Main Results:

  • Out of 27 HTx patients, 23 were discharged from the hospital.
  • 16 patients successfully returned to work or school post-transplantation.
  • Two patients experienced mortality due to infection at 4 months and 4 years post-HTx.

Conclusions:

  • Heart transplantation in Japan, despite limitations, demonstrates positive patient outcomes and return to normal life.
  • Emerging immunosuppressive drugs (sirolimus, everolimus) and advanced VADs offer potential for improved HTx in Japan.
  • Future pediatric heart transplantation in Japan requires careful consideration of legal and medical advancements.

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