Long term follow up of severely ill patients who underwent urgent cardiac transplantation.

OBJECTIVE

To assess long term survival (> 5 years) and quality of life in severely ill patients referred for urgent cardiac transplantation.

SETTING

Tertiary referral centres: before transplantation at the National Heart Hospital (late 1984 to end 1986); after transplantation at Harefield Hospital.

SUBJECTS

Eighteen patients (15 men; three women) who had required intensive support in hospital before cardiac transplantation and were alive at short term follow up.

INTERVENTIONS

Intravenous infusions of cardiac drugs (mean 2.2 infusions), intravenous diuretics (17 patients), and many other drugs before transplantation. Intra-aortic balloon counterpulsation (four patients), temporary pacing (two), and resuscitation from cardiac arrest (three). Patients had specialised nursing care on a medical intensive care unit in almost every case.

MAIN OUTCOME MEASURES

Long term survival in patients after urgent cardiac transplantation and perceived quality of life.

RESULTS

Of 18 patients who were alive at short term follow up (mean (range) 19.4 (10-33) months), 14 were still alive in 1992 (69 (61-83) months). Ten still worked full time, and 11 reported no restrictions in their daily activities. Three of four patients who died in the intervening period survived > 5 years after transplantation. Overall, 17 of 18 patients survived at least 5 years.

CONCLUSIONS

In severely ill patients who undergo urgent cardiac transplantation and survive in the short term, long term (5-7 year) survival and quality of life seem good.