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Korean Circ J. 2019 Mar 20. doi: 10.4070/kcj.2018.0392. [Epub ahead of print]

The Korean Organ Transplant Registry (KOTRY): Second Official Adult Heart Transplant Report.

Author information

1
Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2
Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. choijean5@gmail.com.
3
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
4
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
5
Department of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
6
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES:

This second adult heart transplantation (HTx) report is based on Korean Organ Transplant Registry data submitted on 400 HTxs in recipients of all ages.

METHODS:

From March 2014 to December 2017, a total of 400 HTxs were performed at 4 major centers in Korea. We analyzed demographics and characteristics according to transplant years. Patterns of immunosuppression, allograft rejection, and survival after HTx were analyzed. Donor and recipient age were highlighted.

RESULTS:

Some distinct differences in HTx statistics were noted. Mean donor age increased significantly in the most recent years compared to 2014-2015, while mean recipient age did not change. The proportion of patients on pre-transplant extracorporeal membrane oxygenation (ECMO) increased over time. One-year and intermediate-term survival was significantly worse in patients on pre-transplant ECMO compared to those without mechanical support. Over the years, tacrolimus has increased to become the most frequently used calcineurin inhibitor over cyclosporine, while the number of patients using steroids both at discharge and 1-year follow-up has declined. Age did not affect 1-year survival, but significantly affected intermediate-term survival.

CONCLUSIONS:

From 2014 to 2017, centers were willing to accept older donors to address increasing organ shortages and more patients received transplant under ECMO care. Increasing age was a strong independent factor for intermediate-term survival, however, post-transplant comorbidities did not differ among age groups. Further studies with longer follow-up duration are needed to better understand age-related post-transplant prognosis.

KEYWORDS:

Heart failure; Heart transplantation; Registries

PMID:
31074219
DOI:
10.4070/kcj.2018.0392
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