Risk Factor Analysis of Orthotopic Heart Transplantation

From March 1989 to December 1999, 1,013 heart transplantations were carried out in this center. Univariate analysis of potential risk factors for early death was followed by stepwise logistic regression to determine independent risk factors. Long-term results were assessed by the Kaplan-Meier method. Multivariate comparisons of long-term results were performed using Cox's proportional hazards model. Early mortality was 8.6%. Actuarial survival was 78.1%, 69.4%, and 53.1% at 1, 5, and 10 years, respectively. Mean total ischemic time was 194 minutes. Independent risk factors of early mortality were female recipient, donor age over 50 years, and ischemic heart disease in the recipient. The precise mechanism of the increased early mortality in female recipients should be studied in the future. Although older donor age was a predictor of early mortality, because of the donor shortage, older hearts should not be excluded from the donor pool. Survival was better in patients with dilative cardiomyopathy than in those with ischemic heart disease.