Study on health-related quality of life in patients with advanced heart failure before and after transplantation.

UNLABELLED: Our objective was to evaluate health-related quality of life in patients with advanced heart failure on the waiting list for a heart transplant. MATERIALS AND METHODS: The study was performed using the EUROQOL-5D questionnaire (EQ-5D) on 38 patients (age: 53 +/- 2 years, 82% men) who were analyzed consecutively during the pretransplant period, as well as at 3, 6, and 12 months after transplantation. We excluded pediatric transplants, retransplantations, heart and lung transplantation, and patients scoring below 17 points on the Folstein's Cognitive Mini-Examination. The studied variables included the five dimensions of the EQ-5D test: mobility, self-care, daily activities, pain-discomfort, anxiety and depression; a visual analog scale from 0 to 100; and perception of health status. Statistics included analysis of variance and chi-square tests. Significance was set at P < .05. RESULTS: There were significant differences in all tested parameters. The worst values were observed prior to transplantation, with a significant improvement at 3 months. CONCLUSIONS: Patients with heart failure showed a significant impairment in health-related quality of life before transplantation. The improvement in health-related quality of life was significant and rapidly evident in the posttransplantation period. The most affected dimensions were activities of daily living and pain-discomfort. All dimensions became stable at 3 months, except for anxiety and depression. At 6 to 12 months, a plateau was reached in the feelings of well-being.

Does multiorgan donation influence survival in heart transplantation?

UNLABELLED: Current heart transplant survival in Spain at 1, 5, and 10 years is 80%, 70%, and 60%, respectively. Our objective was to establish how donor type affects survival in heart transplantation. MATERIALS AND METHODS: This was a retrospective study of heart transplant recipients from 102 donors, divided into three types: (a) heart-liver-kidney donors (group I); (b) heart-liver-kidney-lung donors (group II); and (c) heart-liver-kidney-lung-pancreas donors (group III). We excluded retransplantations, pediatric transplantations, and cardiopulmonary transplantations. The outcome variable was the actuarial survival by type of donation. Statistical analysis was performed for event-free survival based on the Kaplan-Meier method (log-rank test). RESULTS: Groups I, II, and III included 63, 26, and 13 donors, respectively. The survival curves showed similar values for all three groups (P > .05). CONCLUSIONS: The different combinations of multiorgan donation do not entail a poorer prognosis in terms of cardiac transplant patient survival.

Study of the evolution of the clinical profile of heart donors.

UNLABELLED: Certain characteristics of the donor have implications for the early and late survival of transplants. The trends show a progressive worsening in the clinical profile of heart donors. Our objective was to analyze changes in the clinical characteristics of donors. MATERIALS AND METHODS: This retrospective study of 396 donors was divided into three periods: 1990 to 1994, 1995 to 1999, and 2000 to 2004. We excluded combination transplantations, retransplantations, and pediatric transplantations. The donor variables included age, cause of death, cardiorespiratory arrest, ICU stay, and ischemia time. Statistical analysis used ANOVA, Kruskall-Wallis, and Chi square test, with significance set at P < .05. RESULTS: Differences were found in age (1990-1994: 27 +/- 1, 1995-1999: 29 +/- 1, 2000- 2004: 34 +/- 1 years; P = .0001), ischemia time (1990-1994: 119 +/- 6, 1995-1999: 145 +/- 4, 2000-2004: 156 +/- 4 minutes; P = .0001), and death from brain hemorrhage (1990-1994: 28%, 1995-1999: 31%, 2000-2004: 43%; P = .031). CONCLUSIONS: There were differences in the clinical characteristics of the donors in the study periods. The age of the donor, stroke-related deaths, and ischemia time have increased significantly in recent years.