Introduction:
Heart transplantation (HTx) remains so far the treatment of choice for selected patients
with advanced heart failure. Since the introduction of cyclosporine in Switzerland in
1986, major advance has been made with respect to diagnosis and treatment of graft
dysfunction, rejection, and transplant-associated infection, resulting in significant
improvement of graft and recipient survival. Despite this, there hasn’t been a lot of
studies that got interested in the long-term survival post HTx, and particularly on the
impact of recipient sex on long-term outcome.
Methods:
461 adult patients that underwent HTx at CHUV or HUG between 1987 and 2022 were
included in this study. Pre-transplant characteristics, intraoperative data and post-
transplantation information were collected and compared according to the sex. The
aim of this retrospective study of a regional cohort is to compare characteristics and
outcome of female and male HTx recipients between 6/1987 and 12/2022.
Results:
In the period from 1987-2022 the mean overall survival after a HTx was of 16,1±1,1
years for adult patients. The percentage of patients alive at 1 year posttransplant was
of 80,9±1.9%; 76.5±2.0% at 3 years; 73.8±2.1% at 5 years; 64.0±2.4% at 10 years;
51.6±2.8% at 15 years and 36.0±3.0% at 20 years. Male recipients had a mean
survival of 14,7±0.7 years while female recipients had a mean survival of 19,5±1.8
years (p=0.009). Female recipients had a better pre-transplant profile with less
comorbidities. There were no significative differences between male and female
patients regarding transplant operation associated parameters.
Conclusion :
This retrospective single-center study of the HTx cohort of the Suisse Romande over
36 years showed that the mean survival after HTx is better in comparison to survival
documented by the ISHLT annual report of 2023 and that long term survival was better
for female recipients when compared with male recipients.