Does heart transplantation confer survival benefit in all risk groups?
Luckraz H; Sharples LD; Charman SC; Tsui SS; Wallwork J; Parameshwar J; Large SR The Transplant Unit, Papworth Hospital, Cambridge, United Kingdom. HeymanLuckraz@aol.com BACKGROUND: Over 50,000 heart transplants have been performed in the last 3 decades. The global shortage of donor organs and the relaxation of candidate selection criteria over time has resulted in recent controversy about the benefits of heart transplantation for some risk groups. We assessed the survival benefit acquired in the Papworth Hospital heart transplant population overall, taking into account resuscitated marginal donors and high-risk recipients. METHODS: All heart transplant patients listed between 1979 and June 2002 were analyzed (n = 1,212). Of these, 931 cardiac transplantations were done, including the use of 126 marginal donors. High-risk recipients (n = 163) were defined as patients being in the hospital, on intravenous inotropic drugs, and/or with a high transpulmonary gradient (>15 mm Hg). Using Cox
