Ten-year heart transplantation experience at the Maritime Heart Center: Does volume affect results?

OBJECTIVE: To evaluate the experience of a small volume Canadian heart transplantation centre. DESIGN: Ninety-four consecutive primary heart transplants were performed from 1988 to 1998 at the Maritime Heart Center, Halilax, Nova Scotia, with 100% follow-up. Kaplan-Meier survival analysis was used. RESULTS: The mean recipient age was 48.5 ± 12.3 years and donor age 33 ± 13.2 years. Eighty per cent of recipients were men. The prevalence of elevated pulmonary vascular resistance (4 or more Wood units) was 20.2%. Etiology of heart failure was ischemic cardiomyopathy (50%), dilated cardiomyopathy (40.9%) and congenital heart disease (9.1%). Survival was 85.9% at one year (n = 71), 75.3% at five years (n = 33) and 60.5% at eight years (n = 8). There was a trend toward survival benefit with human leukocyte antigen (HLA)-DR matching, body mass index ratio of donor to recipient greater than 0.8, ischemic time less than 90 mins and male donors. There was no effect on survival with donor or recipient age, recipient sex, diabetes, hypertension, hypercholesterolemia, elevated pulmonary vascular resistance and HLA-A/B mismatch. CONCLUSIONS: Excellent survival at one and five years following heart transplantation is reported that compares favourably with results published by the International Society for Heart and Lung Transplantation.