Heart Transplantation in a Low-Organ-Donation Environment: A Single Center Experience

Abstract

Objective Heart transplantation is the “gold standard” for treating patients in end-stage heart failure who satisfy strict selection criteria. However, infrequent transplant performance, eg, less than nine per year, may be associated with suboptimal results. Methods We reviewed our 13-year clinical experience (1996–2008) with 73 orthotopic heart transplants performed under strict selection criteria and followed closely thereafter at the only accredited center in Greece, a country with an annual rate of only seven donors per million population. Results Low perioperative (5.47%) and long-term (7.5%) mortality rates were responsible for a 94% survival rate in the first year, 92% at five years, and 70% at ten years—similar to those reported worldwide—along with excellent functional recovery. Conclusion Strict recipient and donor selection criteria, combined with a rigorous multidisciplinary follow-up, yield excellent results despite the existing shortage of available grafts.