eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2020
vol. 17
 
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abstract:
Original paper

Prognosis of heart transplant patients in Mashhad University of Medical Sciences

Mohammad Abbasi Teshnisi
1
,
Farveh Vakilian
1
,
Nahid Zirak
1
,
Alireza Sedaghat
1
,
Seyed Hamid Reza Hoseini Khah
2
,
Amir Hooshang Mohammadpoor
2
,
Vahab Azmonfar
1
,
Farideh Golhasani Keshtan
2
,
Masoumeh Rohani
1
,
Reza Bagheri
1
,
Abbas Ardehali
3

  1. Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  2. Mashhad University of Medical Sciences, Mashhad, Iran
  3. Thoracic Surgeon Ronald Reagan UCLA Medical Center, Santa Monica, USA
Kardiochir Torakochir Pol 2020; 17 (1): 33-38
DOI: https://doi.org/10.5114/kitp.2020.94189
Online publish date: 2020/04/07
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Introduction
Heart transplant is the ultimate treatment for patients with end-stage heart failure.

Aim
To assess 50 heart transplant patients for underlying diseases, transplantation outcome and mortality rate during a 5-year follow-up program.

Material and methods
Fifty heart transplant patients who underwent heart transplantation from 2012 to 2017 were assessed for underlying diseases, organ rejection, duration of hospitalization, extubation time, cardiac output and survival. Biopsy samples were obtained after surgery for evaluation of rejection.

Results
Dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM) were the most common underlying diseases with prevalence of 56% and 12%, respectively. Significant improvement in ejection fraction was observed following heart transplant. Minimum and maximum extubation and hospitalization times were 3–408 hours and 1–51 days, respectively. Organ rejection evaluation 10 days after heart transplantation revealed that 50% of patients did not show any rejection while 10% had severe rejection. At 30 days post-operatively the number of patients with grade III rejection decreased to 2% while 56% of patients had no sign of rejection. The 5-year survival rate was 66% while infection and arrhythmia were the most common causes of death.

Conclusions
DCM and ICM are considered the most prevalent underlying diseases in heart transplant candidates. Ejection fraction reached normal ranges following transplant, which provides good quality of life. Low incidence of severe acute rejection demonstrates the effectiveness of our immunosuppressive therapy. In the cases of increased rejection, the patient’s immunosuppressive regimen was re-assessed accordingly.

keywords:

heart transplant, heart failure, organ rejection, underlying disease, ejection fraction
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