Cardiac transplantation: five years' activity

Area of Science:

• Cardiology
• Transplant Surgery
• Immunology

Background:

• The establishment of new heart transplant programs is crucial for expanding access to life-saving treatments.
• Analyzing early outcomes is essential for program refinement and demonstrating efficacy.

Purpose of the Study:

• To evaluate the initial five-year experience of the heart transplant program at Coimbra University Hospitals.
• To assess patient and graft survival rates, complications, and overall program performance.

Main Methods:

• A retrospective analysis of 132 heart transplant recipients between November 2003 and December 2008.
• Data collection included patient demographics, donor characteristics, surgical techniques, immunosuppression protocols, and clinical outcomes.
• Kaplan-Meier survival analysis was used to determine actuarial survival rates.

Main Results:

• Actuarial survival rates at one and five years were 90% and 82%, respectively.
• Early mortality (within 30 days) was 4.5%, primarily due to graft failure and hyperacute rejection.
• Late mortality (after 30 days) was 10%, with cancer and infection being the leading causes. Rejection episodes were managed effectively with immunosuppression adjustments.

Conclusions:

• The Coimbra University Hospitals heart transplant program achieved outcomes comparable to or better than established centers.
• The program has successfully increased the rate of cardiac transplantation in Portugal, exceeding the European average.
• Continuous self-correction based on program experience has been key to its success.