초록접수 현황
| 14F-276 | 포럼 발표 |
Early and Long-term Results after Heart Transplantation: Single Center Experience During 20-year Period
이재홍, 염상윤, 오홍철, 김용한, 황호영, 김기봉
서울대학교 의과대학 서울대학교병원 흉부외과학교실
Background : We sought to evaluate early and long-term results after heart transplantation (HTPL) and to analyze whether there have been changes in patient characteristics and clinical outcomes.
Methods : 105 patients (51±14 years, 28 females) who underwent HTPL from 1994 to 2013 were enrolled. Dilated cardiomyopathy (n = 57, 54.3%) and ischemic cardiomyopathy (n = 27, 25.7%) were common causes of end-stage heart failure. Early and long-term clinical results including overall survival, infection-free rate and rejection free rate were evaluated. Patient characteristics and clinical outcomes were compared between patients who underwent HTPL before 2008 (group E, n= 33) and after 2008 (group L, n=72) were compared.
Results : Group L patients were older (5514 vs 4211 years, p<0.001), and more frequently had hypertension (p = 0.031) and ischemic cardiomyopathy (p = 0.001) than group E patients. Donors in group L were also older than those in group E (36±12 vs 29±10 years p = 0.006). Thirty-day mortality rate was 3.8% (4 of 105 patients). Postoperative complications included acute renal failure (n = 31, 29.5%), bleeding reoperation (n=15, 14.3%) and wound complications (n = 10, 9.5%). No significant differences in early mortality and postoperative complications were observed between the two groups. 10- and 15-year survival rates were 58% and 46%, respectively. 10-year infection-free and rejection-free rates were 59% and 49%, respectively. No significant differences in overall survival and infection-free rates were found between the groups. However, rejection-free rates were significantly higher in group L than in group E (p < 0.001).
Conclusion : Early and long-term results of HTPL were acceptable with thirty-day mortality rate of 3.8% and 10-year survival rates of 58%. Despite changes in characteristics of HTPL recipients and donors, early and long-term clinical outcomes were similar in the early and late study periods. In addition, rejection rates have decreased significantly over time.
Methods : 105 patients (51±14 years, 28 females) who underwent HTPL from 1994 to 2013 were enrolled. Dilated cardiomyopathy (n = 57, 54.3%) and ischemic cardiomyopathy (n = 27, 25.7%) were common causes of end-stage heart failure. Early and long-term clinical results including overall survival, infection-free rate and rejection free rate were evaluated. Patient characteristics and clinical outcomes were compared between patients who underwent HTPL before 2008 (group E, n= 33) and after 2008 (group L, n=72) were compared.
Results : Group L patients were older (5514 vs 4211 years, p<0.001), and more frequently had hypertension (p = 0.031) and ischemic cardiomyopathy (p = 0.001) than group E patients. Donors in group L were also older than those in group E (36±12 vs 29±10 years p = 0.006). Thirty-day mortality rate was 3.8% (4 of 105 patients). Postoperative complications included acute renal failure (n = 31, 29.5%), bleeding reoperation (n=15, 14.3%) and wound complications (n = 10, 9.5%). No significant differences in early mortality and postoperative complications were observed between the two groups. 10- and 15-year survival rates were 58% and 46%, respectively. 10-year infection-free and rejection-free rates were 59% and 49%, respectively. No significant differences in overall survival and infection-free rates were found between the groups. However, rejection-free rates were significantly higher in group L than in group E (p < 0.001).
Conclusion : Early and long-term results of HTPL were acceptable with thirty-day mortality rate of 3.8% and 10-year survival rates of 58%. Despite changes in characteristics of HTPL recipients and donors, early and long-term clinical outcomes were similar in the early and late study periods. In addition, rejection rates have decreased significantly over time.
책임저자: 김기봉
서울대학교 의과대학 서울대학교병원 흉부외과학교실
연락처 : 이재홍, Tel: 02-2072-2348 , E-mail : holyjh85@naver.com
