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Updated: Jun 22, 2026
A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
Published on: February 14, 2022
Heart transplantation
1Department of Organ Transplantation, National Cardiovascular Center, Suita, Japan. tnakatan@hsp.ncvc.go.jp
Insights
Japan
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
Background:
- Since 1997, Japan has performed 59 heart transplantations (HTx).
- Most recipients had dilated cardiomyopathy and were status 1, with a mean wait time of 777 days.
- 85% of patients utilized left ventricular assist systems (LVAS) as a bridge to transplantation, averaging 780 days of support.
Purpose of the Study:
- To analyze the outcomes of heart transplantation in Japan.
- To evaluate the effectiveness of LVAS as a bridge to HTx.
- To assess long-term survival rates in Japanese HTx recipients.
Main Methods:
- Modified bicaval technique for cardiac preservation using Celsior solution.
- Initial immunosuppression involved triple therapy: cyclosporine, mycophenolate mofetil, and steroids.
- Data collected up to September 2008, covering procedures since October 1997.
Main Results:
- Achieved a 9-year survival rate of 94%.
- This survival rate surpasses international registry benchmarks.
- Excellent outcomes were observed despite donor shortages and long LVAS support durations.
Conclusions:
- Heart transplantation in Japan yields excellent results.
- The use of LVAS is crucial for bridging patients to transplantation.
- Despite donor scarcity, Japanese HTx program demonstrates high efficacy and survival.
Abstract:
A total of 59 heart transplantations (HTx) have been performed in Japan as of September, 2008, since the Organ Transplantation Law was settled in October 1997. The majority of recipients were suffered from dilated cardiomyopathy and waiting condition of all recipients were status 1. The mean waiting time was 777 day; 50 patients (85%) were supported by several types of left ventricular assist systems (LVAS) and the mean duration of support was 780 days. The majority of patients underwent operation by modified bicaval method with Celsior solution for cardiac preservation, and 64% of recipients were administered triple therapy with cyclosporine, mycophenolate mofetil, and steroid as the initial immunosuppressive regimen. The 9-year survival rate was 94%, which was superior to that of the international registry. HTx in Japan has been very limited by a severe shortage of donors, but the results have been excellent even though the majority of recipients were waiting for long-term with a LVAS as a bridge to HTx.
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