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Three decades of heart transplantation in Scandinavia: long-term follow-up

Dellgren, Goran; Geiran, Odd; Lemstrom, Karl; Gustafsson, Finn; Eiskjaer, Hans; Koul, Bansi LU ; Hagerman, Inger and Selimovic, Nedim (2013) In European Journal of Heart Failure 15(3). p.308-315
Abstract
Aim Heart transplantation (HTx) has become a standard treatment for patients with end-stage heart disease. The aim of this study was to report the long-term outcome after HTx in Scandinavia. Methods and results During the period, 1983-2009,2333 HTxs were performed in 2293 patients (mean age 45 +/- 16 years, range 0-70,78% mate). The main indications for HTx were non-ischaemic cardiomyopathy (50%), ischaemic cardiomyopathy (34%), valvular cardiomyopathy (3%), congenital heart disease (7%), retransplantation (2%), and miscellaneous (4%). The registry consists of pre-operative data from recipients and donors, data from pre-operative procedures, and long-term follow-up data. Mean follow-up was 7.8 +/- 6.6 years (median 6.9, interquartile range... (More)
Aim Heart transplantation (HTx) has become a standard treatment for patients with end-stage heart disease. The aim of this study was to report the long-term outcome after HTx in Scandinavia. Methods and results During the period, 1983-2009,2333 HTxs were performed in 2293 patients (mean age 45 +/- 16 years, range 0-70,78% mate). The main indications for HTx were non-ischaemic cardiomyopathy (50%), ischaemic cardiomyopathy (34%), valvular cardiomyopathy (3%), congenital heart disease (7%), retransplantation (2%), and miscellaneous (4%). The registry consists of pre-operative data from recipients and donors, data from pre-operative procedures, and long-term follow-up data. Mean follow-up was 7.8 +/- 6.6 years (median 6.9, interquartile range 2.5-12.3, interval 0-27) and no patients were lost to follow-up. Long-term survival for HTx patients was 85, 76, 61, 43, and 30% at 1, 5, 10, 15, and 20 years of follow-up, respectively. Ten-year survival in patients bridged with mechanical circulatory support, in children, after retransplantation, and after concomitant other organ transplantation was 56, 74, 38, and 43%, respectively. Older patients (age >55 years) had a significantly worse survival (P < 0.001). Patients transplanted more recently had a significantly better survival (P < 0.001). In a multivariate Cox regression analysis, independent predictors of long-term survival were recipient age (P < 0.001), donor age (P < 0.001), diagnosis (P = 0.001), and era of transplantation (P < 0.001). Conclusions HTx in Scandinavia proves to have a significantly better survival among patients transplanted in the last decade. HTxs from mechanical circulatory support, in children, after retransplantation, and with concomitant other organ transplantation were performed with acceptable results. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Heart transplantation, Bridge-to-transplantation, Cardiac, retransplantation, Long-term follow-up
in
European Journal of Heart Failure
volume
15
issue
3
pages
308 - 315
publisher
Elsevier
external identifiers
  • wos:000316161500011
  • scopus:84874483481
ISSN
1879-0844
DOI
10.1093/eurjhf/hfs160
language
English
LU publication?
yes
id
5e6a41e0-ff67-4dd8-b4fb-6c2623baa069 (old id 3657203)
date added to LUP
2013-05-02 08:54:19
date last changed
2019-03-17 03:07:13
@article{5e6a41e0-ff67-4dd8-b4fb-6c2623baa069,
  abstract     = {Aim Heart transplantation (HTx) has become a standard treatment for patients with end-stage heart disease. The aim of this study was to report the long-term outcome after HTx in Scandinavia. Methods and results During the period, 1983-2009,2333 HTxs were performed in 2293 patients (mean age 45 +/- 16 years, range 0-70,78% mate). The main indications for HTx were non-ischaemic cardiomyopathy (50%), ischaemic cardiomyopathy (34%), valvular cardiomyopathy (3%), congenital heart disease (7%), retransplantation (2%), and miscellaneous (4%). The registry consists of pre-operative data from recipients and donors, data from pre-operative procedures, and long-term follow-up data. Mean follow-up was 7.8 +/- 6.6 years (median 6.9, interquartile range 2.5-12.3, interval 0-27) and no patients were lost to follow-up. Long-term survival for HTx patients was 85, 76, 61, 43, and 30% at 1, 5, 10, 15, and 20 years of follow-up, respectively. Ten-year survival in patients bridged with mechanical circulatory support, in children, after retransplantation, and after concomitant other organ transplantation was 56, 74, 38, and 43%, respectively. Older patients (age &gt;55 years) had a significantly worse survival (P &lt; 0.001). Patients transplanted more recently had a significantly better survival (P &lt; 0.001). In a multivariate Cox regression analysis, independent predictors of long-term survival were recipient age (P &lt; 0.001), donor age (P &lt; 0.001), diagnosis (P = 0.001), and era of transplantation (P &lt; 0.001). Conclusions HTx in Scandinavia proves to have a significantly better survival among patients transplanted in the last decade. HTxs from mechanical circulatory support, in children, after retransplantation, and with concomitant other organ transplantation were performed with acceptable results.},
  author       = {Dellgren, Goran and Geiran, Odd and Lemstrom, Karl and Gustafsson, Finn and Eiskjaer, Hans and Koul, Bansi and Hagerman, Inger and Selimovic, Nedim},
  issn         = {1879-0844},
  keyword      = {Heart transplantation,Bridge-to-transplantation,Cardiac,retransplantation,Long-term follow-up},
  language     = {eng},
  number       = {3},
  pages        = {308--315},
  publisher    = {Elsevier},
  series       = {European Journal of Heart Failure},
  title        = {Three decades of heart transplantation in Scandinavia: long-term follow-up},
  url          = {http://dx.doi.org/10.1093/eurjhf/hfs160},
  volume       = {15},
  year         = {2013},
}