Consistent improvements in short‐ and long‐term survival following heart transplantation over the past three decades. Issue 4 (10th February 2021)

• Record Type: Journal Article
• Authors: Reul, Ross M.; Zhang, Theodore S.; Rana, Abbas A.; Rosengart, Todd K.; Goss, John A.
• Is Part Of: Clinical transplantation. Volume 35:Issue 4(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-02-10
• Subjects: heart transplantation -- long term -- outcomes -- survival; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.14241
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: Despite noted improvements in short‐term survival outcomes following orthotopic heart transplantation (OHT), review of the relevant literature suggests little improvement in long‐term outcomes for patients surviving beyond 1 year. Methods: All OHT cases performed between 1989 and 2019 within the United Network for Organ Sharing (UNOS) database were reviewed. Adults who underwent isolated OHT were included in a 1‐year survival analysis. Those who survived at least 1 year post‐transplant were included in a long‐term survival analysis. Demographic factors were assessed using Students' t test and chi‐square analysis. Survival trends and risk factors were assessed using the Kaplan‐Meier and the Cox regression analysis, respectively. Results: A total of 53 265 and 46 372 recipients were included in the short‐term and long‐term cohorts, respectively. In an adjusted analysis, the reference implant era 2014‐2019 had significantly better short‐term survival outcomes when compared with earlier implant eras: 1989‐1993 (HR: 2.92), 1994‐1998 (HR: 1.53), 1999‐2003 (HR: 1.27), 2004‐2008 (HR: 1.11), and 2009‐2013 (HR: 1.02). The same trend was recognized for long‐term outcomes: 1989‐1993 (HR: 1.87), 1994‐1998 (HR: 1.27), 1999‐2003 (HR: 1.09), and 2004‐2008 (HR: 1.03). Conclusions: Despite increases in multiple traditional risk factors, both short‐term and long‐term survival outcomes have consistently improved over the past 30 years, suggesting other factors are contributing to improved outcomes in recent eras.