Related Experiment Video
Updated: May 30, 2025
A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
Published on: February 14, 2022
Advancement of Heart Transplantation in Thai Recipients: Survival Trends and Pharmacogenetic Insights
Siwaporn Manomaisantiphap1, Pasawat Boon-Yasidhi1, Napatsanan Tanathitiphuwarat2
1Faculty of Medicine, Department of Pharmacology, Chulalongkorn University, Bangkok, Thailand.
Insights
King Chulalongkorn Memorial Hospital has improved heart transplant survival rates since 1987. Pharmacogenetic analysis shows advancements in treating advanced heart failure, with infection remaining a key mortality cause.
Area of Science:
- Cardiology
- Transplantation Immunology
- Pharmacogenetics
Background:
- King Chulalongkorn Memorial Hospital (KCMH) has a long history of performing heart transplants for advanced heart failure since 1987.
- Assessing long-term outcomes and understanding factors influencing survival are crucial for improving patient care.
Purpose of the Study:
- To analyze and compare heart transplant survival rates in Thailand between different eras.
- To investigate the role of pharmacogenetics in immunosuppressant therapy post-heart transplantation.
- To identify common pre-transplant diagnoses and causes of mortality.
Main Methods:
- Retrospective retrieval of data from electronic medical records for all heart transplant recipients from 1987 to 2021.
- Kaplan-Meier survival analysis to compare outcomes across different time periods.
- Pharmacogenetic genotyping of relevant genes in recipients alive during the study period.
Main Results:
- Overall survival rates have significantly improved in the recent era compared to earlier periods.
- Dilated cardiomyopathy was the most frequent pre-transplant diagnosis.
- Infection was identified as the primary cause of mortality among heart transplant recipients.
Conclusions:
- Heart transplantation at KCMH has seen substantial advancements, leading to improved patient survival.
- Pharmacogenetic variations may play a role in transplant outcomes, warranting further investigation.
- Future research should focus on genetic-guided immunosuppression to optimize post-transplant care and outcomes.
Abstract:
Since 1987, King Chulalongkorn Memorial Hospital (KCMH) has performed a substantial number of heart transplants as a specific therapy for advanced-stage heart failure. This descriptive study aimed to analyze post-transplant survival in the recent era compared to earlier periods and examine the pharmacogenetics of related immunosuppressants. Data from all recipients who underwent heart transplants from 1987 to 2021 were retrospectively retrieved from the electronic medical record. The genotypes of relevant pharmacogenes were analyzed in recipients who were alive during the enrollment period. Kaplan-Meier analysis revealed improved overall survival rates in the recent era compared to the past. Dilated cardiomyopathy was identified as the most common pretransplant diagnosis, while infection remained the leading cause of mortality. In conclusion, the findings demonstrate significant advancements in the quality of heart transplantation in Thailand. Future studies are warranted to explore the correlation between pharmacogenetic variations identified in this study and subsequent clinical outcomes, with a focus on genetic-guided treatment to optimize patient care.
