2005, Number 3
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ABSTRACTObjective:To assess survival in patients subjected to cardiac transplantation as compared to those that received only medical treatment or some other surgical alternative.
Setting:Third level health care hospital.
Design: Retrospective, observational, comparative study.
Statistical analysis:The SPSS12.0 statistical software for Windows was used. Survival was determined by the Kaplan-Meier method and the qualitative variables by means of chi-square.
Patients and methods:We studied a cohort of patients admitted to our transplantation program between January 1987 and July 2001. We included 60 patients and divided them in three groups: Group 1, transplanted patients (n = 20); Group 2a, non-transplanted patients with a ‹ 20% ejection fraction (EF) (n = 20); Group 2b, non-transplanted patients with an EF › 20%, (n = 20). We recorded age, gender, etiology of the cardiopathy, EF, functional class (NYHA), return to working activity, time of cold ischemia of the transplanted organ, endocardiac biopsy findings, immunosuppressor scheme, date and cause of death. Survival was determined by the Kaplan-Meier method.
Results:There were no differences in the recorded variables among the studied groups. Survival in Group 1 patients was of 70 and 50% at 1 and 8 years, respectively; there were no survivors in group 2a at 1 year; in group 2b, survival was of 25% at 2 years (p ‹ 0.001). Transplanted patients remained in functional class I of NYHA, returning all of them to their social and working activities.
Conclusion:Cardiac transplantation, as treatment for end-stage cardiac failure remains to be better than medical management and than palliative surgical and technological procedures in terms of survival and quality of life.
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