Non-Fontan Adult Congenital Heart Disease Transplantation Survival Is Equivalent to Acquired Heart Disease Transplantation Survival

• Published in: The Annals of thoracic surgery Vol. 101; no. 5; pp. 1768 - 1773
• Main Authors: Besik, Josef, Szarszoi, Ondrej, Hegarova, Marketa, Konarik, Miroslav, Smetana, Michal, Netuka, Ivan, Pirk, Jan, Maly, Jiri
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.05.2016
• Subjects: Adolescent; Adult; Cardiothoracic Surgery; Cold Ischemia; Czech Republic - epidemiology; Donor Selection; Female; Heart Defects, Congenital - mortality; Heart Defects, Congenital - surgery; Heart Diseases - mortality; Heart Diseases - surgery; Heart Transplantation - mortality; Humans; Intraoperative Complications - mortality; Kaplan-Meier Estimate; Male; Middle Aged; Patient Selection; Postoperative Complications - mortality; Risk Factors; Surgery; Survival Rate; Treatment Outcome; Young Adult
• ISSN: 0003-4975; 1552-6259; 1552-6259
• DOI: 10.1016/j.athoracsur.2015.10.088

As a result of improved diagnostic methods, medical treatment, surgical correction, and palliation in childhood, there is a growing number of adult patients with congenital heart disease (CHD) who may experience heart failure and subsequently require heart transplantation (HT). Because of complex anatomy, previous operations, and frequently increased pulmonary vascular resistance (PVR), these patients represent a group with a higher risk of early mortality after transplantation. From May 1999 to December 2014, our institution performed 25 HTs in adult patients with end-stage CHD. We present our data and outcomes of transplantation in this group. The median age at transplantation was 38 years (range, 18.4–53.7 years). Survival was 88% at 30 days, 88% at 1 year, and 77% at 5 years. We identified long donor heart ischemic time (>4 hours) as an important risk factor for early mortality. There was no significant difference in the survival of patients undergoing transplantation for CHD and patients undergoing transplantation for other diagnoses. With careful donor and recipient selection, adults with end-stage CHD undergoing HT can achieve excellent early and midterm survival, comparable to the survival of patients who undergo transplantation for other diagnoses.