A Comprehensive Retrospective Cohort Study on Heart Transplantation: Exploring Complications, Mortality Causes, and Survival Rates.

Highlights: High Survival Rates: The study reported 1-year, 5-year, and 10-year survival rates of 80%, 51%, and 42%, respectively, for heart transplant recipients.Key Complications: Allograft rejection occurred in 23.8% of patients, significantly impacting survival, with a mean survival of 23.9 months for those with rejection versus 65.9 months without.Leading Cause for Transplant: Dilated cardiomyopathy was the most common underlying condition, accounting for 85.3% of heart transplant cases.Demographic Insights: The cohort had a mean age of 40.7 years, with 64% male recipients, and no significant survival differences based on sex or age. Background: Heart transplantation (HTx) has become the preferred treatment for certain individuals with advanced heart failure. However, the outcomes and complications of this procedure have not been thoroughly evaluated in the Iranian population. In this study, we aimed to provide a comprehensive understanding of the epidemiological characteristics of patients who underwent HTx, focusing on the indications for HTx, early and late complications, causes of mortality, and survival rates. Methods: In this retrospective cohort study, we included all patients aged 18 years and older who underwent HTx between July 2013 and June 2023 at Namazi Academic Hospital, affiliated with Shiraz University of Medical Sciences. We collected baseline and clinical characteristics and 10-year follow-up data from medical records. The 10-year survival data were presented using the Kaplan-Meier curve. Subgroup survival analyses based on Allograft rejection status, sex, and age were also performed. Results: We identified 75 patients who underwent HTx during the study period, including 48 males and 27 females. The most prevalent underlying cause for HTx was dilated cardiomyopathy, accounting for 85.3% of the surgeries. After the procedure, 15 patients showed signs of allograft rejection. The survival analysis indicated a mean survival of 71.3 ± 6.5 months. The 1-, 5-, and 10-year survival rates were reported at 80%, 51%, and 42%, respectively. Conclusions: Overall, this study's findings offer valuable insights into the demographic and clinical characteristics of patients undergoing HTx and their outcomes. Additionally, our results enhance current knowledge regarding pre-HTx risk assessment and patient selection, early post-HTx diagnosis, and the management of significant complications.