Destiny of Heart Transplant Candidates Based on a High Volume Heart Transplant Center Experience in Iran

Abstract

Background
The waiting list of heart transplantation is a valuable data registry which would provide very useful information regarding the characteristics of patients who have different destinies while waiting in the list. This study aimed to investigate the destiny of patients on heart transplant waiting list and the risk factors for the highest mortality.
Methods:
The demographic, clinical, hemodynamic and echocardiographic findings of advanced heart failure patients who were registered in the national registry for heart transplantation between 2011 and 2018, as well as the destiny of them were extracted. The study population was defined and compared in four groups: 1) death while awaiting HTX, 2) Death after HTX, 3) Alive without a transplant, 4) Transplanted and alive.
Results:
The data of 207 patients [75% male, mean (SD) age of 34(10) years] were analyzed. The most common etiology of heart failure was idiopathic dilated cardiomyopathy. A total of 86 patients (41%) were successfully transplanted, with a median (IQR) time between listing and transplantation of 84 (30-219) days, 54 patients (26.1%) were dead and 32% were still alive. The multivariate analysis showed right atrial pressure, pulmonary capillary wedge pressure, cardiac index, and systolic blood pressure at the time of listing as independent predictors of death.
Conclusion:
The study on HTX waiting list is very useful for both allocation strategies and administrative planning for patients with advanced heart failure by development of accurate models and scoring systems using predictors of death in the waiting list.