Heart-lung transplantation – single center experience

Objectives: Combined heart-lung transplantation (HLTx) is a last treatment option for patients with end-stage cardiopulmonary disease, which may improve survival and a quality of life. The aim of the study was to present single center experience with HLTx.

Methods: Between February 1983 and September 2009, 74 patients aged from 2.2 to 54.7 years (mean, 29.4±13.6 years) underwent orthotopic heart-lung transplantation in our center. The preoperative diagnosis was congenital heart defect in 35 (47.3%) (group 1) and lung disease in 39 (52.7%) patients (group 2). Demographic, clinical perioperative and long-term data were retrospectively analyzed.

Results: The mean follow-up for the whole study population was 4.29±4.6 years (range, 0 days to 14.3 years). Actuarial 0.5, 1, 5 and 10 year survival was 62.5%, 60.0%, 53.4%, 43.2% in group 1, and 68.7%, 63.7%, 41.0%, 26.2% in group 2, respectively, and did not differ between the groups (p=0.232). There were no differences between the groups regarding the duration of intensive care unit stay (p=0.266), ventilatory support time (p=0.145), as well as the incidence of late complications: obliterative bronchiolitis (p=0.121), graft coronary artery disease (p=0.541), incidence of tumors (p=0.0715), episodes of rejection (p=0.545) and renal insufficiency (p=0.220).

Conclusions: In spite of a high mortality combined heart-lung transplantation is nowadays an established saving option for many patients. In our experience the nature of indication for HLTx does not change the long-term results.