Evolution of heart transplant recipient characteristics over four decades: a single-center experience
G Heredia Campos, R Gonzalez Manzanares, I Gallo Fernandez, M Diaz Andrade, L C Maestre Luque, C Urbano Sanchez, L Calvo Gutierrez, F Hidalgo Lesmes, S Ojeda Pineda, A Lopez Granados, D Mesa Rubio, M Pan Alvarez-Ossorio, M Anguita Sanchez, M Crespin CrespinAbstract
Introduction
Since its inception in the 1980s, there has been a significant change in the characteristics of heart transplant (HT) recipients, including the type of heart disease, diagnosis, and therapeutic options.
Method
An observational, retrospective, and longitudinal study of real-world clinical practice was conducted, including all patients over 18 years old who underwent HT at our hospital. Patients were classified into three groups based on the year of transplantation: Group 1 (1986–2000), Group 2 (2001–2012), and Group 3 (2012–2024).
Results
Significant differences were found in several areas:
- Underlying Heart Disease: Idiopathic and ischemic cardiomyopathy decreased, while hypertrophic, restrictive, and familial types increased.
- Comorbidities: Reductions in COPD and prior extracorporeal surgery were noted.
- Devices and Status: There was a marked increase in ICD and CRT carriers, as well as VA-ECMO use as a bridge to transplant.
- Clinical State: A shift toward lower NYHA classes and a lower percentage of pulmonary hypertension was observed.
Conclusion
The characteristics of HT recipients have evolved, showing more precise diagnosis, changes in bridge-to-transplant ventricular assist devices, and a trend toward transplanting patients at less advanced stages.For image description, please refer to the figure legend and surrounding text.