PMID- 24728425
OWN - NLM
STAT- MEDLINE
DCOM- 20141211
LR  - 20211203
IS  - 0717-6163 (Electronic)
IS  - 0034-9887 (Linking)
VI  - 141
IP  - 12
DP  - 2013 Dec
TI  - [Clinical experience with 53 consecutive heart transplants].
PG  - 1499-505
LID - S0034-98872013001200001 [pii]
LID - 10.4067/S0034-98872013001200001 [doi]
AB  - INTRODUCTION: Heart transplantation is the therapy of choice for advance heart 
      failure. Our group developed two transplant programs at Instituto Nacional del 
      Torax and Clinica Davila. We report our clinical experience based on distinctive 
      clinical policies. PATIENTS AND METHODS: Fifty-three consecutive patients were 
      transplanted between November 2008 and April 2013, representing 51% of all 
      Chilean cases. Distinctive clinical policies include intensive donor management, 
      generic immunosuppression and VAD (ventricular assist devices) insertion. 
      RESULTS: Ischemic or dilated cardiomyopathy were the main indications (23 (43%) 
      each), age 48 +/- 13 years and 48 (91%) were male. Transplant listing Status: IA 14 
      (26%) (VAD or 2 inotropes), IB 14 (26%) (1 inotrope) and II25 (47%) (no 
      inotrope). Mean waiting time 70 +/- 83 days. Twelve (24%) were transplanted during 
      VAD support (median support: 36 days). OPERATIVE TECHNIQUE: orthotopic bicaval 
      transplant with ischemia time: 175 +/- 54 min. Operative mortality: 3 (6%), all due 
      to right ventricular failure. Re-exploration for bleeding 2 (4%), stroke 3 (6%), 
      mediastinitis 0 (0%), pneumonia 4 (8%), and transient dialysis 6 (11%). Mean 
      follow-up was 21 +/- 14 months. Three-year survival was 86 +/- 6%. One patient died 
      of Pneumocystis jirovecii pneumonia and the other died suddenly (non-compliance). 
      Freedom from rejection requiring specific therapy was 80 +/- 7% at 3 years of 
      follow-up. Four hundred eighty four endomyocardial biopsies were done: 11 (2.3%) 
      had 2R rejection. All survivors are in NYHA (New York Heart Association) 
      functional class I and all but one have normal biventricular function. 
      CONCLUSION: Mid-term results are similar to those reported by the registry of the 
      International Society for Heart and Lung Transplantation. This experience has a 
      higher proportion of VAD support than previous national series. Rejection rates 
      are low in spite of generic immunosuppression.
FAU - Villavicencio, Mauricio
AU  - Villavicencio M
FAU - Rossel, Victor
AU  - Rossel V
FAU - Larrea, Ricardo
AU  - Larrea R
FAU - Peralta, Juan Pablo
AU  - Peralta JP
FAU - Larrain, Ernesto
AU  - Larrain E
FAU - Sung Lim, Jong
AU  - Sung Lim J
FAU - Rojo, Pamela
AU  - Rojo P
FAU - Gajardo, Francesca
AU  - Gajardo F
FAU - Donoso, Erika
AU  - Donoso E
FAU - Hurtado, Margarita
AU  - Hurtado M
LA  - spa
PT  - Journal Article
TT  - Experiencia clinica con 53 trasplantes cardiacos consecutivos.
PL  - Chile
TA  - Rev Med Chil
JT  - Revista medica de Chile
JID - 0404312
SB  - IM
MH  - Adult
MH  - Cardiomyopathy, Dilated/epidemiology/surgery
MH  - Chile/epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection
MH  - *Graft Survival
MH  - Heart Failure/epidemiology/*surgery
MH  - Heart Transplantation/mortality/*statistics & numerical data
MH  - Heart-Assist Devices/statistics & numerical data
MH  - Humans
MH  - Immunosuppression Therapy/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Registries
MH  - Retrospective Studies
MH  - Tissue Donors
EDAT- 2014/04/15 06:00
MHDA- 2014/12/17 06:00
CRDT- 2014/04/15 06:00
PHST- 2012/10/24 00:00 [received]
PHST- 2013/10/28 00:00 [accepted]
PHST- 2014/04/15 06:00 [entrez]
PHST- 2014/04/15 06:00 [pubmed]
PHST- 2014/12/17 06:00 [medline]
AID - S0034-98872013001200001 [pii]
AID - 10.4067/S0034-98872013001200001 [doi]
PST - ppublish
SO  - Rev Med Chil. 2013 Dec;141(12):1499-505. doi: 10.4067/S0034-98872013001200001.