Predictors of mortality following heart transplantation: Spanish Registry of Heart Transplantation 1984-2001

Because the number of heart transplants performed at each center is rather low, multicenter registries are designed to analyze a large number of transplants to draw reliable conclusions. Objective. To determine the factors associated with early and late mortality following heart transplantation. Materials and methods. All heart transplants performed in Spain since the start of transplant activity (May 1984) to December 31, 2001 were subjected to multivariate test using Cox regression in blocks of variables grouped into donor, recipient, immunosuppression, surgical and follow-up variables (a total of 111 metrics). Results. Among the 3786 transplants early survival at 30 days after transplant was 86%, while survivals at 1, 5, and 10 years were 76%, 63%, and 50%. Variables associated with early mortality included acute graft failure, pulmonary vascular resistance > 2.5 Wood Units (WU), prior thoracic surgery, respiratory obstruction, donor treatment with dobutamine, ventricular assistance, hepatic and/or renal dysfunction, hyperuricemia, mechanical ventilation, prior infection, duration of ischemia and/or extracorporeal circulation > 4 hours. Variables associated with late mortality were: acute graft failure, graft vascular disease, tumors, rejection, infection, dialysis, and hypertension. Conclusions. Multicenter records provide reliable information on heart transplants in our country, revealing factors associated with mortality for future solutions.