Correlation of Transplant Vasculopathy with Long-Term Survival

Introduction

Survival after heart transplantation (HTx) has improved, largely due to improvements in early survival. The current half-life time after HTx is now about 10 years [1], [2], [3]. In agreement with data from the ISHLT registry but in contrast to data from Oeynhausen [3], the DHZB experience demonstrates significantly improved survival in patients transplanted between 1992 and 2001 [2]. In contrast to registry data, survival after HTx after 2001 at the DHZB is not improved in comparison with the preceding period ([Fig. 1]).

Fig. 1 Survival after HTx at DHZB conditional on 1-month survival stratified with respect to time period of HTx.

Fig. 2 Survival conditional on 5-year survival, no children, HTx later than 1991.

References

• 1 Roussel J C, Baron O, Perigaud C, Bizouarn P, Pattier S, Habash O. et al . Outcome of heart transplants 15 to 20 years ago: graft survival, post-transplant morbidity, and risk factors for mortality.  J Heart Lung Transplant. 2008;  27 486-493
• 2 Taylor D O, Edwards L B, Boucek M M, Trulock E P, Aurora P, Christie J. et al . Registry of the International Society for Heart and Lung Transplantation: twenty-fourth official adult heart transplant report – 2007.  J Heart Lung Transplant. 2007;  26 769-781
• 3 Tjang Y S, van der Heijden G J, Tenderich G, Grobbee D E, Korfer R. Survival analysis in heart transplantation: results from an analysis of 1290 cases in a single center.  Eur J Cardiothorac Surg. 2008;  33 856-861
• 4 Wellnhofer E, Hiemann N E, Hug J, Dreysse S, Knosalla C, Graf K. et al . A decade of percutaneous coronary interventions in cardiac transplant recipients: a monocentric study in 160 patients.  J Heart Lung Transplant. 2008;  27 17-25
• 5 Eisen H J, Tuzcu E M, Dorent R, Kobashigawa J, Mancini D, Valantine-von Kaeppler H A. et al . Everolimus for the prevention of allograft rejection and vasculopathy in cardiac-transplant recipients.  N Engl J Med. 2003;  349 847-858
• 6 Kobashigawa J A. Statins and cardiac allograft vasculopathy after heart transplantation.  Semin Vasc Med. 2004;  4 401-406
• 7 Kobashigawa J A, Tobis J M, Mentzer R M, Valantine H A, Bourge R C, Mehra M R. et al . Mycophenolate mofetil reduces intimal thickness by intravascular ultrasound after heart transplant: reanalysis of the multicenter trial.  Am J Transplant. 2006;  6 (5 Pt 1) 993-997