Heart Transplant Allows Long-Term Survival For Nearly
Half Of CHF Patients

	July 7, 1999 - Nearly 50% of 120 end-stage CHF
patients who had a heart transplant are still alive
10 years later. "Heart transplant is the most effective
treatment for patients with end-stage heart failure," Dr.
S. Fraund from Hannover Medical School in Germany, says
in the July issue of Heart. "However, only limited data are 
available on the long-term success of this procedure."
	To address this issue, they studied the long-term
survival and functioning of 120 patients who had heart
transplant between October of 1984 and October of 1987.
The underlying disease was dilated cardiomyopathy in 69
patients and coronary artery disease in 42, with the other
9 patients having other assorted diagnoses.
	In this group, 65% of the patients survived at 5
years and 48% at 10 years. Fifty-eight of 120 patients
survived longer than 10 years. In general, exercise
tolerance was "good" in long-term survivors, as was left
ventricular function. Only 16 patients showed "severe"
allograft vasculopathy, and "renal function was only
slightly impaired," according to the report.
	"These results are far superior to medical
treatment alone," Dr. Fraund says. They were unable to
identify factors that determined which patients would
benefit most from heart transplant.
	The authors conclude that "heart transplant
should be regarded as a valuable option" for patients
with end-stage heart failure. In the future, the German
team says, the major obstacles to be overcome in the
management of heart transplant patients will be the
prevention of chronic graft vasculopathy and malignancies.
These diagnoses accounted for 39% and 11% of deaths in the
studied group.

Heart 1999;82:47-51