[Survival after heart transplantation in Norway]

Heart transplantation has been a treatment option in Norway for selected patients with terminal congestive heart failure since 1983. The number of transplants is limited by donor availability. Few Norwegian doctors are aware of the challenges to be expected in taking care of heart transplant recipients. In the present paper we therefore present our experience so far.

We have followed individuals within our patient cohort for up to 22 years. The cohort consists of 522 patients (mean age 48.8 years +/- 13.6), somewhat unequally distributed from various parts of the country, reflecting the local referring practice. We have a complete overview of the patients who are partly followed up locally, but come to a control at least once a year at our hospital.

Mean survival in these patients is 12 years. With an expected survival of less than one year without transplantation, these are strong results that compare well with international figures. Patients younger than 50 years at transplantation have the best prognosis regardless of donor age, while the combination of patients older than 50 years and donor above 35 years have the poorest chance of survival. However, patients are disposed to various severe complications. Initially after transplantation acute rejection, unspecific graft failure and infections are a threat; while complications such as chronic graft sclerosis, renal failure and cancer are complications that appear over time. To optimise results, life-long regular follow up is necessary.