Abstract
This mortality study deals with the 1068 heart transplants (1054 patients) performed in Italian Units from November 1985 to April 1992. The death rate was 19.7% and the actuarial survival was 89% at 1 month, 83% at 1 year and 74% at 6.5 years. Recipients who died had been less often transplanted for dilated cardiomyopathy, were older (44.1 vs. 41.7 years) and more often male (84.5 vs. 72.7%). Analysis of the causes of death was restricted to orthotopic transplantations (1029/1068 procedures, 195/208 deaths). Deaths were grouped within four intervals: peri-operative (≤1 month, 50.0% of deaths), early (>1 month ≤3 months, 17.2%), intermediate (>3 months ≤2 years, 22.6%) and late (>2 years, 10.2%). The prime causes of death were mostly postoperative graft failure (whose effects brought about 64% of peri-operative deaths, 28% of early and 7% of intermediate deaths), post-operative complications (10% of peri-operative deaths), acute rejection (10% of total deaths, distributed in all the periods), graft arteriopathy (6% of early, 36% of intermediate and 58% of late deaths), infections (17% of deaths, occurring in all periods but late) and malignant tumours (7% of deaths), lymphomas being the first to occur and Kaposi's sarcoma occuring only in the intermediate period. Repeat transplantation had a poor outcome (death rate 71.4%), two-thirds of the re-transplanted patients' deaths being due to early graft failure and a third to late relapsing graft vasculopathy.
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Supported by FATMA Project, National Council of Research (CNR), Italy
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Gallo, P., Baroldi, G., Thiene, G. et al. When and why do heart transplant recipients die? A 7 year experience of 1068 cardiac transplants. Vichows Archiv A Pathol Anat 422, 453–458 (1993). https://doi.org/10.1007/BF01606453
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DOI: https://doi.org/10.1007/BF01606453