Results and Experience from Berlin

Introduction

Heart transplantation (HTx) at the German Heart Institute Berlin, DHZB, started 22 years ago in 1986 when the DHZB was founded. A total of 1 698 cardiac transplantations have been performed between April 1986 and May 2008 1&986 and May 2008. 1 557 patients received a heart transplant (1259 males and 298 females). 46 patients were re-transplanted (20 in an acute and 26 in a chronic disease situation) and 95 patients received heart-lung transplantation ([Table 1]).

Table 1 Heart transplantation program, Deutsches Herzzentrum Berlin, 04/1986–05/2008. Organs 1 698 Heart transplantation 1 557 pts Men 1 259 Women 298 Re-transplantation 46 pts Acute 20 Chronic 26 Heart-Lung transplantation 95 pts

HTx Long-term survival ≥ 15 years

Our database includes 211 patients with a total survival of ≥ 15 years after HTx and 199 patients with survival of ≥ 15 years after primary HTx. As of June 2008, 162 patients were alive ≥ 15 years after primary HTx and 12 patients ≥ 15 years after repeat HTx.

HTx Long-term survival ≥ 20 years

A substantial number of patients is surviving more than two decades after HTx: The database includes 49 patients with a total survival of ≥ 20 years after HTx and 48 patients with survival of ≥ 20 years after primary HTx. As of June 2008, 47 patients were alive ≥ 20 years after primary HTx and 3 patients ≥ 20 years after repeat HTx.

Quality of life (QoL) follow-up study of 154 long term survivors 15–23 years after HTx

Since 1987 patients were evaluated before HTx and 1 year, 10, 15 and > 20 years after HTx (follow-up). 125 patients could be assessed 10 years after HTx, 88 patients 15 years and 16 patients > 20 years after HTx (cut-off June 2008). The aim of the study was to evaluate QoL-related “protective” factors that might impact long-term survival and could possibly explain why some HTx recipients live longer than others. Assessments included semistructured interviews, psychiatric rating scales, coping and social support scales and QoL questionnaires.

Reference

• 1 Hetzer R, Potapov E V, Müller J, Loebe M, Hummel M, Weng Y, Warnecke H, Lange P E. Daily noninvasive rejection monitoring improves long-term survival in pediatric heart transplantation.  Ann Thorac Surg. 1998;  66 (4) 1343-1349