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Heart transplantation is a promising treatment for end-stage heart failure due to dilated cardiomyopathy. Patients experience improved physical capacity and cardiac function, with good long-term survival rates.
Area of Science:
- Cardiology
- Transplantation Medicine
Context:
- End-stage heart failure from dilated cardiomyopathy is a primary indication for heart transplantation.
- Clinical judgment, not solely prognostic indicators, guides transplantation decisions.
Purpose:
- To evaluate the outcomes of orthotopic heart transplantation in patients with end-stage heart failure, particularly those with dilated cardiomyopathy.
Summary:
- 50 patients underwent heart transplantation, 38 with dilated cardiomyopathy, between 1983 and present.
- Survival rates are 60-80% at one year and over 50% at five years.
- 38 patients are alive, 34 discharged, 14 returned to work/school with normal physical capacity and cardiac function.
Impact:
- Heart transplantation offers a promising routine treatment for end-stage heart failure, especially in younger dilated cardiomyopathy patients.
- Outcomes, including rejection and infection rates, are comparable between dilated cardiomyopathy and coronary artery disease patients.
Abstract:
Within the spectrum of presently accepted candidates for heart transplantation, end-stage heart failure in dilated cardiomyopathy has become the principle indication. Although several indicators of poor prognosis have been specified, the decision for heart transplantation is primarily made on clinical grounds. Expected long-term survival after transplantation is 60 to 80% at one year and more than 50% at five years. Since July, 1983, 50 patients underwent orthotopic heart transplantation, 38 of whom had been suffering from dilated cardiomyopathy. Ages ranged from nine to 54 years with a mean of 40 years. At present, 38 patients are alive, 34 are discharged from hospital, 14 have returned to work or school. Physical capacity and cardiac function are normal. There was no difference between the cardiomyopathy patients and the coronary artery disease patients with respect to rate and severity of rejection episodes, infection and long-term findings. Heart transplantation is considered a promising routine treatment for end-stage heart failure in particular in younger patients with dilated cardiomyopathy.