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Heart transplantation in Finland 1985-1995

S Mattila¹, L Heikkilä, J Sipponen

¹Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland.

Annales Chirurgiae Et Gynaecologiae

|January 1, 1997

Summary

This study on heart transplantation in Finland from 1985-1995 found that survival improves significantly after the initial postoperative period. Cytomegalovirus infection is a major risk, but prognosis is good long-term if patients survive the first three months.

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Area of Science:

Cardiology
Transplantation Medicine
Immunology

Background:

Heart transplantation has become a well-established treatment for end-stage heart failure since the 1980s.
The first heart transplant in Finland occurred in 1985, with activity increasing to approximately 25 transplants annually.

Purpose of the Study:

To summarize the clinical experience of heart transplantation in Finland over its first 11 years (1985-1995).

Main Methods:

Analysis of 190 heart transplantations performed between February 1985 and December 1995.
Patient demographics and underlying cardiac conditions (dilating cardiomyopathy, coronary artery disease, valvular disease, congenital heart disease) were recorded.

Main Results:

Thirty-day hospital mortality was 15.2% (29/190).

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Actuarial survival rates were 77% at 1 year, 75% at 2 years, and 73% at 10 years.

Leading causes of death included rejection, graft failure, abdominal complications, and cytomegalovirus (CMV) infection. CMV infection was linked to post-transplant coronary artery disease.

Conclusions:

Patients surviving the first three postoperative months have a good long-term prognosis.
Clinically significant rejections affect less than one-third of patients.
Cytomegalovirus is a significant post-transplant complication and a risk factor for coronary artery disease; sympathetic nervous control shows some recovery within three years.