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Updated: Jul 14, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
[Global experience and results of heart transplantation]
Javier Gallego1, F Valera, J A Margarit
1Serviço de Cirurgia Cardio-Torácica do Hospital de Santa Maria, Lisboa e Serviço de Cirurgia Cardiovascular do Hospital Universitário de La Fe, Valencia.
Insights
This 19-year study of heart transplantation shows low early mortality and improving survival rates. Future efforts should focus on graft vascular disease to enhance long-term outcomes for heart transplant recipients.
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Immunology
Context:
- Over 19 years (1987-2005), 439 heart transplantations were performed at Hospital Universitario La Fe.
- Analysis included indication variation, donor/receptor profiles, and urgent vs. programmed procedures.
Purpose:
- To summarize the experience and results of heart transplantation over a 19-year period.
- To correlate outcomes with surgical techniques, myocardial protection, and immunosuppression protocols.
Summary:
- Early mortality was 8% (4.7% in the last period), with acute graft failure and infection as primary early causes of death.
- Ischemic cardiomyopathy was the most frequent indication (41%). Graft vascular disease became the leading cause of mortality after the first year.
- Heart transplantation remains the optimal treatment for end-stage cardiomyopathies, with stable transplant numbers influenced by donor availability.
Impact:
- The study demonstrates comparable survival rates to international literature, with a positive trend in recent years.
- Highlights the need for improved prevention and treatment of graft vascular disease to increase long-term survival.
- Provides valuable data on surgical outcomes and patient profiles in heart transplantation.
Objectives:
This article summarizes the general experience and results achieved by heart transplantation during 19 years of activity.
Materials And Methods:
Between 1987 and 2005, 439 heart transplantations and 24 cardiopulmonary transplantations were performed by the Cardiovascular Surgery Department of Hospital Universitario La Fe, Valencia, Spain. Indication variation over time, donor/receptor profiles, urgent vs. programmed transplantations and short/long term results over different periods of time were subject to analysis, while correlating the results with changes of surgical technique, myocardial protection and immunosuppression protocols.
Results:
For the last 5 years, the number of heart transplantations remained stable at 30 cases per year. The most frequent etiology was ischaemic cardiopathy (41%); 25% of the emergency heart transplantations were carried out in patients with inotropic support, mechanical ventilation and/or intraaortic balloon pump contrapulsation. The early mortality rate was 8%, and 4,7% considering only the last period; the most frequent cause of death during the first postoperative month was acute graft failure, followed by infection. After the first year, graft vascular disease was the leading cause of mortality. Emergency transplantation and re-transplantation had a significantly higher mortality.
Conclusions:
Cardiac transplantation is the best treatment for terminal miocardiopathies. The early mortality rate was low. At present time, the number of heart transplantations became stable due to a low number of donors. In the future, better prevention and treatment of graft vascular disease shall be achieved in order to increase long-term survival. The comparative analysis of survival shows similar results to others published in the world scientific literature, including a continuing trend towards improving survival over the last years.
