[Heart-lung transplantation. Causes of failure in the first postoperative month]

The aim of the study was to assess the cause of heart and heart-lung transplants failure during the first month following surgery. Data were collected from France Transplant records from 1985 to 1989. Two thousand and ninety one heart transplantations were collected. Four hundred and fifty one patients died in the first month; only 290 records were fully analyzed among them. Failure was due to: early graft failure (33 percent), infection (17 percent), multiple organs failure (18 percent), rejection (9 percent), others (23 percent). Related factors were: lack of experience from the team, prolonged organ preservation, patient's youth, severe heart failure. One hundred and fifty two heart-lung transplantations were collected. From 1985 to 1987, the first month failure average exceeded 60 percent, post-operative infections and early graft failures being the main causes (65 percent). Since the last 2 years, mortality has been decreasing (40 percent). Prolonged organ preservation appears to be a major related factor.