Heart failure & cardiomyopathies
Four Decades of Heart–Lung Transplantation: Milestones and Outcomes in Advanced Cardiorespiratory Failure
Authors' conclusion
HLTx outcomes at our centre are consistent with international benchmarks. Survival has improved in Era 2, likely due to individualised immunosuppressive regimens, novel organ preservation techniques and enhanced surveillance. These results support ongoing optimisation of multidisciplinary care for complex cardiopulmonary failure.
Study context
- Population
- Patients with severe cardiorespiratory failure who underwent heart-lung transplantation (HLTx), with follow-up through June 2024patients who underwent HLTx between 1983–1995 (Era 1) and 1996–2010 (Era 2)
- Participants
- 80 patients
- Exposure
- Survival in Era 1 vs Era 2
- Outcome
- All-cause mortality (survival)
- Follow-up
- 1, 5 and 10 years post-transplant
Main finding
As reported in the abstract
| Group | 1 year | 5 years | 10 years |
|---|---|---|---|
| Era 1 | 46 ± 10% | 18 ± 9% | 9 ± 6% |
| Era 2 | 66 ± 7% | 5 ± 7% | 45 ± 7% |
1 year
Era 146 ± 10%
Era 266 ± 7%
5 years
Era 118 ± 9%
Era 25 ± 7%
10 years
Era 19 ± 6%
Era 245 ± 7%
- Overall survival at 1 year
- 60 ± 6%
- Overall survival at 5 years
- 46 ± 6%
- Overall survival at 10 years
- 35 ± 6%
Observational data: associations, not effects.
Secondary outcomes
Risks for mortality
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| Heart failure | 4.557 (1.057–19.648) | P = 0.042 | |
| Gastrointestinal bleeding | 2.739 (1.310–5.726) | P = 0.016 | |
| 0.050.21520Odds ratio (log scale) |
- Risks for mortality: These factors remained significant in multivariable analysis.
Univariable risk factors for increased mortality
- Euro Collins versus Perfadex lung preservation
- P < 0.001
- University of Wisconsin (UW2) versus Histidine-Tryptophan-Ketoglutarate (HTK) solution cardioplegia
- P < 0.001
- Epstein-Barr virus infection
- P = 0.036
Original publication
Four Decades of Heart–Lung Transplantation: Milestones and Outcomes in Advanced Cardiorespiratory Failure. ESC Heart Fail. Published 27 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it