CONICET | Buscador de Institutos y Recursos Humanos

Background: Heart transplantation is still the treatment of choice in patients with severe cardiomyopathies that do not have any therapeutic options. The promising results of heart transplantation in terms of survival have modified the criteria of recipients? selection, including more complex patients on the waiting list. Objective: The aim of this report is to analyze the outcomes of heart transplantation performed at the Hospital Universitario Fundación Favaloro after 21 years of follow-up. Methods: Between February 1993 and December 2014, 442 orthotopic heart transplantations were performed at a single center. The clinical records of the recipients, excluding pediatric patients, were retrospectively analyzed, ensuring the confidentiality of the information. Two periods were considered: period 1 (from February 1993 to August 2003) and period 2 (from September 2003 to December 2014). Results: During the second period, the prevalence of recipients with non ischemic versus ischemic dilated cardiomyopathy was higher, and the indication of heart transplantation in Chagas dilated cardiomyopathy showed a significant increase. The prevalence of pulmonary hypertension increased and more emergency heart transplantations were performed, with requirements of inotropic agents and mechanical circulatory support with intraaortic balloon pump. Conclusions: The clinical profile of heart transplantation recipients has changed and more patients on the waiting list have a greater number of comorbidities. The careful selection of candidates for transplantation needs continuous revision and an individual analysis of the different factors that determine patients? survival and its impact on the outcomes of transplantation programs.

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