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Mortality after heart-lung transplantation experience in a reference center
M T Izquierdo1, L Almenar, P Morales
1Heart Failure and Transplant Unit, Department of Cardiology, La Fe University Hospital, Valencia, Spain.
Transplantation Proceedings
|September 25, 2007
Summary
Heart-lung transplantation (HLT) shows high mortality. However, patients with Eisenmenger syndrome may represent a lower-risk group for this procedure.
Area of Science:
- Cardiology
- Thoracic Surgery
- Transplantation Medicine
Background:
- The International Society for Heart and Lung Transplantation registry noted varied mortality rates post-heart-lung transplantation (HLT) based on etiology.
- Analyzing center-specific HLT outcomes is crucial for refining patient selection and post-operative care.
Purpose of the Study:
- To analyze mortality rates following heart-lung transplantation (HLT) at our institution.
- To identify potential differences in outcomes based on the underlying etiology for HLT.
Main Methods:
- A retrospective analysis of 25 HLT procedures performed between January 1991 and December 2006.
- Patients were categorized into four etiologic groups: Eisenmenger type congenital heart disease, primary pulmonary hypertension, COPD with right ventricular impact, or pulmonary dysfunction with left ventricular depression.
- Exclusion of three patients who did not fit defined etiologic categories.
Main Results:
- Overall hospital survival was 59%, with 1-year survival at 50% and 5-year survival at 37%.
- The cohort had a mean age of 38 years, 62% males, and a mean ischemia time of 198 minutes.
- In the Eisenmenger's syndrome cohort, there were no in-hospital deaths, and 5-year survival was 50%.
Conclusions:
- Heart-lung transplantation (HLT) remains a high-risk procedure with significant overall mortality.
- Congenital heart disease of the Eisenmenger type appears to be associated with a lower risk profile and better survival post-HLT.
- Further research into etiology-specific outcomes can optimize HLT strategies.
