Hector Rodriguez Cetina Biefer and Markus J. Wilhelm from the University Hospital Zurich in Switzerland led a research team that examined long-term outcomes in 133 patients from their institution who underwent heart transplantation from 1985 to 1991.
Among those patients, 74 (55.6 percent) survived at least 20 years post-transplantation. The average age at transplant for the 20-year survivors was 43.6 years.
Major causes of death in non-survivors were graft rejection (21 percent), malignancy (21 percent), cardiac allograft vasculopathy (an accelerated form of coronary artery disease; 14.5 percent), and infections (14.5 percent).
Wilhelm said that a remarkable number of patients survived 20 years or more following heart transplantation, confirming the procedure as the 'gold standard' for end-stage heart failure, at least for the time being.
Wilhelm asserted that with continued improvements in immunosuppressive management in the coming years, they expect to see transplant patients living longer, healthier lives, adding that it is still uncertain if mechanical circulatory support devices will be able to compete with heart transplantation in the future.
The study is published in the February issue of The Annals of Thoracic Surgery.