When and why do heart transplant recipients die? A 7 year experience of 1068 cardiac transplants

Pietro Gallo, Giorgio Baroldi, Gaetano Thiene, Lucio Agozzino, Eloisa Arbustini, Giovanni Bartoloni, Edgardo Bonacina, Cesare Bosman, Gualtiero Catani, Patrizia Cocco, Cira di Gioia, Teresio Motta, Angela Pucci, Maurizio Rocco

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This mortality study deals with the 1068 heart transplants (1054 patients) performed in Italian Units from November 1985 to April 1992. The death rate was 19.7% and the actuarial survival was 89% at 1 month, 83% at 1 year and 74% at 6.5 years. Recipients who died had been less often transplanted for dilated cardiomyopathy, were older (44.1 vs. 41.7 years) and more often male (84.5 vs. 72.7%). Analysis of the causes of death was restricted to orthotopic transplantations (1029/1068 procedures, 195/208 deaths). Deaths were grouped within four intervals: peri-operative (≤1 month, 50.0% of deaths), early (>1 month ≤3 months, 17.2%), intermediate (>3 months ≤2 years, 22.6%) and late (>2 years, 10.2%). The prime causes of death were mostly postoperative graft failure (whose effects brought about 64% of peri-operative deaths, 28% of early and 7% of intermediate deaths), post-operative complications (10% of peri-operative deaths), acute rejection (10% of total deaths, distributed in all the periods), graft arteriopathy (6% of early, 36% of intermediate and 58% of late deaths), infections (17% of deaths, occurring in all periods but late) and malignant tumours (7% of deaths), lymphomas being the first to occur and Kaposi's sarcoma occuring only in the intermediate period. Repeat transplantation had a poor outcome (death rate 71.4%), two-thirds of the re-transplanted patients' deaths being due to early graft failure and a third to late relapsing graft vasculopathy.

Original languageEnglish
Pages (from-to)453-458
Number of pages6
JournalVirchows Archiv A Pathological Anatomy and Histopathology
Issue number6
Publication statusPublished - Nov 1993


  • Allograft rejection
  • Cardiac transplantation
  • Graft arteriopathy
  • Mortality
  • Tumours

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Anatomy


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