(RxWiki News) Heart transplant patients who are younger and receive organs at experienced hospitals are significantly more likely to survive a decade after transplantation.
Johns Hopkins researchers found that individuals under the age of 55 who receive heart transplants at medical facilities that perform at least nine heart transplants annually were much more likely to be alive 10 years later.
"Seek transplant services at experienced medical facilities."
Dr. Arman Kilic, a surgical resident at The Johns Hopkins Hospital and leader of the study, noted that up to 2,500 heart transplants are performed each year in the U.S., and many patients die still waiting for an organ. Doctors must wisely allocate scarce organs, and the research helps suggest which patients will live longer with a new heart, he said.
During the study investigators combed through data collected by the United Network of Organ Sharing, focusing on more than 22,000 American adults who received heart transplants between 1987 and 1999. About half of the patients were still alive 10 years later.
Researchers compared 9,404 heart transplant recipients who survived at least 10 years with 10,373 who did not. About 3,000 patients were lost during the follow up process.
They identified several factors that may help predict living at least a decade after the operation. Patients age 55 and younger had a 24 percent greater chance of surviving 10 years as compared to older patients.
Donor age also was important. For each decade younger the donor was, patients were 10 percent more likely to live longer. White patients also were more likely to live at least 10 years after the operation as compared to minority patients.
Those who received the procedure at a facility that performed at least nine heart transplants a year were 31 percent more likely to survive the next decade. Dr. Kilic said the better survival rate at more experienced hospitals was not only tied to surgeon experience with heart transplants, but also because such facilities are better equipped to manage complex post-operative care.
Patients also were 11 percent more likely to survive 10 years for each hour reduction that the heart was out of the body as it travels from the donor to the recipient.
Sicker patients on ventilators before their transplants were 47 percent more likely to die within 10 years, while diabetics were 33 percent less likely to survive.
Patients receive hearts from the national waiting list based on how sick they are, and most recipients are not expected to survive another month without a transplant. Dr. Kilic suggests the findings could be used to give priority among the sickest patients most likely to survive the longest.
"These data could be used for both prognosis and allocation purposes," Kilic says. "They help predict which patients have the best chance to derive the longest and most sustainable benefit from the limited number of hearts that become available each year."
Michelle Segovia, a spokeswoman for the Texas Organ Sharing Alliance, noted that in addition to making transplant decisions based on how sick patients are, compatible blood and tissue matching and the proximity of the potential recipient to the donor also play a role.
"While this study suggests which patients might have better outcomes with a transplanted heart, the problem remains the critical shortage of donor hearts and all other transplantable organs," Segovia said. "If more people donated their organs when they died, more people would get the transplants they need."
The study was recently published in The Annals of Thoracic Surgery.