Original article: cardiovascularHeterotopic Heart Transplantation: An Expanding Role in the Twenty-First Century?
Section snippets
Patients
Since the inception of the heart and lung transplant program at The Alfred Hospital, Australia, in March 1989, until the end of September 2003 this unit performed 420 heart transplants. The heterotopic heart transplant program was initiated in August 1997, and 20 male patients had undergone this procedure by the end of September 2003. During the same period 131 orthotopic heart transplants were performed and will be used to provide contemporary outcome comparisons.
The inclusion criteria for
Results
Mean follow-up for the heterotopic group was 25 months (range, 0 to 67 months) and for the orthotopic cohort 34 months (range, 0 to 75). Hospitalization and outcome data are detailed in Table 3.
Comment
The main benefits of using the heterotopic heart transplant are the ability to transplant patients with a high pulmonary vascular resistance and the ability to use organs that would otherwise be wasted. The predominant indication for heterotopic heart transplant is high pulmonary artery pressures in the recipient. This is because of the previously documented poor survival in these patients who undergo orthotopic transplantation 2, 5. Nakatani and associates [5] showed good intermediate-term
Acknowledgements
We acknowledge the statistical assistance of Michael Bailey in the Department of Epidemiology and Preventative Medicine, Monash University, Melbourne; the assistance of Anne Griffiths, Julie Johns, and Sharon Daly for data collection for the manuscript; and Leah B. Edwards, Associate Director of Data Analysis for the International Society for Heart and Lung Transplantation, for the data used in our comparative analyses.
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