[Posttransplant complications in cardiac transplant recipients at National Cardiovascular Center]

We have performed 21 cases of heart transplantation at our institution. We retrospectively reviewed the complications and its incidence in those post transplant course.

Twenty-one heart transplant recipients (aged at transplant 14 to 61 year old, 16 male and 5 female, observation period: 4 to 99 months) were retrospectively reviewed. Transplant coronary artery disease (TxCAD) was defined as existence of severer than Stanford class IV maximum intimal thickness seen by intra-coronary ultrasound at their annual evaluation. The incidence of hypertension, diabetes, hyperlipidemia, renal dysfunction and malignancy were also reviewed.

One patient died after 4.3 year posttransplant due to systemic infections. Eight patients (38.1%) developed TxCAD, 4 patients (19%) developed hypertension, 2 patients (9.5%) developed diabetes, 1 patient (4.8%) developed hyperlipidemia. Renal insufficiency defined as serum creatinine level of greater than 1.5 mg/dl was seen in 2 patients (9.5%), however none of them showed severe renal dysfunction such as serum creatinine level of greater than 2.0 mg/dl or requiring dialysis. No malignancy was seen in our patients. Cellular rejection episodes requiring admission for treatment were seen in 3.1% of all biopsies performed.

Survival rate of our cardiac transplant recipients was 95.2% at 8.3 years. TxCADs and renal insufficiency were seen in 38% and 9.5% of our patients respectively, however the incidences of these complications were lower than those in ISHLT 2006 registry. Even in Japan, long-term survivors after cardiac transplantation are increasing. Maintenance of not only the cardiac function but also other organ function is required in post transplant care.