7. Single-center experience of heart transplantation at the heart center of Astana

Аннотация

Background. Chronic heart failure is a major global health issue. As a complication of most cardiovascular diseases, it affects 4% of the population. Heart transplantation is the gold standard in the treatment of patients with end-stage heart failure. Objective of the study was to evaluate early and long-term outcomes of heart transplants performed at the Heart Center University Medical Center (Heart Center) over a 10-year period.

Materials and methods. Cross-sectional study was conducted from 2012 to 2022, 86 orthotopic heart transplants were performed at the Heart Center. The analysis of the obtained results was conducted retrospectively.

Results. From August 2012 to December 2022, 114 patients were on the waiting list for heart transplantation. Of these, 86 (75.4%) patients underwent transplantation; 10 (8.7%) patients were excluded. Among the 86 patients, 49 (56.9%) had previously undergone cardiac surgery. Of these, 42 (48.8%) had a left ventricular assist device implanted earlier, 3 (3.4%) had a fully artificial heart, and 2 (2.5%) were on temporary mechanical support (central veno-arterial Extracorporeal membrane oxygenation). Hospital mortality was 8 (9.3%) recipients. In 2.7% of cases, the cause of death was an acute cerebrovascular accident on the second day post-surgery. Postoperative renal dysfunction was noted in 28 (32.5%) patients. An analysis of all performed heart transplantation cases showed a 30-day survival rate of 94%, a 1-year survival rate of 84.3%, and a 5-year survival rate of 64.7%.

Conclusion. In the hospital period and the first 6 months after heart transplantation, infectious-septic complications were predominant, whereas in later periods, rejection reactions were more common.