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[Current state in heart transplantation]
K Yasuda1, K Ishii, M Watanabe
1Department of Cardiovascular Surgery, Hokkaido University Hospital, Sapporo, Japan.
[Hokkaido Igaku Zasshi] the Hokkaido Journal of Medical Science
|March 1, 1995
Summary
Global heart transplantation data until 1993 shows coronary artery disease and cardiomyopathy as primary indications. Survival rates improved significantly after 1982, but challenges remain for elderly, pediatric, and retransplantation patients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Surgical Outcomes
Context:
- The International Society for Heart and Lung Transplantation Registry provides global data on organ transplantation.
- Heart transplantation procedures have been performed worldwide since the registry's inception.
- Donor heart shortages impact the overall number of heart transplantations performed annually.
Purpose:
- To analyze global heart transplantation statistics up to 1993.
- To identify primary indications for adult heart transplantation.
- To evaluate actuarial survival rates and factors influencing outcomes.
Summary:
- Until 1993, over 26,000 heart transplantations were performed globally, with coronary artery disease (47.2%) and cardiomyopathy (43.5%) as leading causes.
- Actuarial survival rates show significant improvement post-1982, with 3-year survival increasing from 40% to 75%, coinciding with the introduction of cyclopropane.
- Outcomes are poorer for patients over 65, pediatric patients under one year, and heart retransplantations. Mechanical assist devices are used as a bridge to transplantation due to donor heart scarcity.
Impact:
- Highlights the substantial progress in heart transplantation survival rates.
- Identifies specific patient demographics with reduced outcomes, suggesting areas for future research and clinical focus.
- Underscores the ongoing challenge of donor organ availability and the role of mechanical circulatory support.