Ten-year heart transplantation experience at the Maritime Heart Center: Does volume affect results?

OBJECTIVE: To evaluate the experience of a small volume Canadian heart tran splantation centre. DESIGN: Ninety-four consecutive primary heart transplants were performed fr om 1988 to 1998 at the Maritime Heart Center, Halifax, Nova Scotia, with 10 0% follow-up. Kaplan-Meier survival analysis was used. RESULTS: The mean recipient age was 48.5 +/- 12.3 years and donor age 33 +/ - 13.2 years. Eighty per cent of recipients were men. The prevalence of ele vated pulmonary vascular resistance (4 or more Wood units) was 20.2%. Etiol ogy of heart failure was ischemic cardiomyopathy (50%), dilated cardiomyopa thy (40.9%) and con genital heart disease (9.1%). Survival was 85.9% at one year (n = 71), 75.3% at five years (n = 33) and 60.5% at eight years (n = 8). There was a trend toward survival benefit with human leukocyte antigen (HLA) -DR matching, body mass index ratio of donor to recipient greater tha n 0.8, ischemic time less than 90 mins and male donors. There was no effect on survival with donor or recipient age, recipient sex, diabetes, hyperten sion, hypercholesterolemia, elevated pulmonary vascular resistance and HLA- A/B mismatch. CONCLUSIONS: Excellent survival at one and five years following heart trans plantation is reported that compares favourably with results published by t he International Society for Heart and Lung Transplantation.