Heart transplantation at the Peruvian National Heart Institute: One-decade single-center experience

J Card Surg. 2022 Jun;37(6):1550-1558. doi: 10.1111/jocs.16429. Epub 2022 Mar 19.

Abstract

Background: Heart transplantations are ideal for most patients with end-stage heart failure refractory to medical treatment. The transplantation program at the Peruvian National Heart Institute started with a 10-year continuity in 2010.

Objective: To compare our 10-year heart transplantation experience results with international standards and reflect on our Transplant Program.

Methods: We studied 83 patients who underwent orthotopic heart transplantation at a single center between January 2010 and December 2019. The recipients' profiles and survival rates were analyzed according to sex and age group, ensuring the information's confidentiality.

Results: The recipients' mean age was 41.2 ± 17 years, 88% were adults, and 68.7% were male. The main indications for transplantation were idiopathic dilated cardiomyopathy. 85.5% of recipients were clinically categorized as INTERMACS profiles 1-3 before transplantation. There was a significant difference between sexes regarding the preoperative left ventricular ejection fraction and between age groups regarding the waiting time. The average ischemia time was 3.1 h, operating time was 6.1 h, cardiopulmonary bypass time was 3 h, and aortic cross-clamp time was 1.7 h. The principal early postoperative complications were hematological disorders and acute kidney failure. The principal late ones were kidney failure and severe anemia. The postoperative mortality was 15.9%, and the principal causes were infection and then acute rejection. The survival at 1, 5, and 10 years was 87.5%, 79.8%, and 79.8%, respectively. The survival results were not influenced by sex or age group.

Conclusion: Our patients' postoperative complications, mortality, and survival rates coincided with those reported by the ISHLT registry.

Keywords: cardiac surgery; heart failure; heart transplantation; survival; transplant recipients.

MeSH terms

  • Adult
  • Female
  • Heart Transplantation* / methods
  • Humans
  • Male
  • Middle Aged
  • Peru / epidemiology
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Stroke Volume
  • Survival Rate
  • Ventricular Function, Left*
  • Young Adult