Single Centre Experience with Prolonged Waiting Time on Transplant List with “High-Urgency” Status

Abstract

The waiting list for heart transplantation (HTx) in Eurotransplant area has grown to a record size of nearly 1,300 patients, whereas only around 600 hearts were transplanted last year. The prolonged time for patients awaiting HTx on the high-urgency (HU) status leads mostly to serious medical complications. The aim of this study was to study the trend of changes in the frequency of ventricular assist device (VAD) implantation in patients on the HU status. A total of 22 adult patients awaiting transplantation on the HU status at our hospital between January 2011 and December 2011 were analyzed, assessing risk profile, blood group, and complication rates in terms of VAD implantation or death. Results were compared with 16 consecutive patients who were on transplant list with the HU status between January 2010 and December 2010 at our institution. Mean age was 49.5 ± 12.1 (2010 group) years and 51.4 ± 10.7 years (2011 group; p = 0.62). Mean logEuroSCORES raised not significantly from 9.1 ± 6.3% (2010 group) to 10.7 ± 14.7% (2011 group; p = 0.68). Six patients died on the HU status and seven patients had to be supplied with a VAD in 2011. In comparison with the preceding year, only two patients died in 2010 and none of our patients on the HU status had to be provided with mechanical circulatory support. Because of the prolonged waiting time on the HU list, the earlier-mentioned data demonstrate a negative trend in transplant medicine. Especially when taking into consideration that five of seven patients who needed a VAD implantation during the HU waiting period had blood group O. Furthermore, the data derived from Eurotransplant show that the waiting period for patients with blood group O was considerably longer when compared with patients of the same average body height and weight but with other blood groups.