The Impact of First Year Clinical Variables of Heart Transplant Recipients on Ten-Year Survival

Objective: Heart transplantation (HTx) is the treatment of choice for patients with end-stage heart failure. It is important to determine the factors related to long-term mortality at HTx. We aim to evaluate the effect of the first year clinical variables on 10-year survival at HTx. Methods: The data of 76 consecutive adult HTx recipients who survived more than 1 year after transplantation between April 1998 and July 2007 in a tertiary medical center were retrospectively evaluated. The survival status was checked for each patient at December 2018. We analyzed the effect of renal function through creatinine levels, average resting heart rate, acute rejection episodes, infections, and left ventricular ejection fraction (LVEF) within the first year after HTx on survival. Results: The mean age was 41 [+ or -] 12 years. Percentage of male was 84%. Median survival was 145 [+ or -] 32 months (95% CI, 80.72-209.27), and 36 out of 76 (47.3%) patients died during follow-up. LVEF was found lowered in nonsurvived group compared to survived ones [57.2 [+ or -] 5.8% vs 59.3 [+ or -] 2.1% (P = .043)]. Cox regression analyses revealed that only LVEF and creatinine at the end of the first year after HTx were found to be significantly associated with mortality [(HR = 0.91, 95% CI, 0.85-0.98, P = .012) and (HR = 1.09, 95% CI, 1.68-5.67, P < .001), respectively]. Conclusion: Decrease in LVEF and high serum creatinine level at the end of the first year after HTx were found to be associated with poor 10-year survival in HTx recipients. Keywords: Heart transplantation, renal insufficiency, mortality