Background:
In 2007, the University Hospital of Lausanne established the multi-disciplinary Heart Transplantation (HTx) team to improve quality of peri-transplant care. Comparison of the period 2000-2007 and 2008-2014 showed a decrease of in-hospital mortality from 22.2 to 16.2% and a reduction of 1-year all cause mortality (ACM) from 25.8% to 18.9% (p=0.612). This study investigates whether decreased mortality early post-transplant is associated with pre-transplant characteristics of HTx recipients.
Methods and Results:
A total of 140 patients were included with HTx recipients operated between the years 2000 to 2007 (n=66) and 2008 to 2014 (n=74). Mean age of all patients was 53.5 years (IQR 47.3- 59.8), 112 males, donor/recipient mismatch was present in 38.3% of patients, length of in- hospital stay was 34 days (IQR 26-61 days); donor age was 41 years (IQR 26-51 years). There was no respective difference between patients operated 2000-2007 and 2008-2014. HTx recipients operated between the years 2008-2014 less often had dilated cardiomyopathy of non-ischemic origin (43.2 vs 63.6%; p=0.024), received more often resynchronization therapy (66.2 vs. 33.3%; p=0.0002), AICD treatment (60.8 vs. 21.2%; p<0.0001), or assist device treatment (24.3 vs. 9.1%; p=0.030). Mean stay on the waiting list was longer (177 vs. 110 days; p=0.04). Baseline hemodynamic data, echocardiographic parameters, cardiovascular risk factors, comorbidity load, and baseline clinical parameters were not different between groups. Diabetes mellitus was a predictor of in-hospital and 1-year ACM in patients operated between 2000 and 2007.
Conclusion:
Characteristics of HTx recipients and donors were not significantly different between HTx recipients operated between the years 2000 to 2007 and 2008 to 2014 suggesting that establishment of a HTx team improved early outcome after HTx.