[Spanish registry on heart transplantation. 22nd official report of the Spanish Society of Cardiology Working Group on Heart Failure and Heart Transplantation (1984-2010)].

INTRODUCTION AND OBJECTIVES The purpose of this report is to present the results obtained with heart transplantation since this therapeutic modality first began to be used in Spain in May 1984. METHODS A descriptive analysis was performed of all heart transplantation performed until December 31, 2010. RESULTS The total number of transplants is 6291. The average clinical profile of the Spanish heart transplant patient in 2010 was that of a 53-year-old male diagnosed with nonrevascularizable ischemic heart disease accompanied by severely depressed ventricular function and poor functional status. The implanted heart was typically from a 39-year-old donor who had died from brain hemorrhage. The average time on the waiting list was 99 days. Mean survival time has progressively increased over the years. Whereas for the overall series, the probability of survival at 1, 5, 10, and 15 years was 78%, 67%, 54%, and 40%, respectively, over the past 5 years the probability of survival at 1 and 5 years was 85% and 73%, respectively. The most frequent cause of death was acute graft failure (16.5%), followed by infection (15.9%), the combination of graft vascular disease and sudden death (13.7%), tumors (11.9%), and acute rejection (7.8%). CONCLUSIONS The transplantation survival rates obtained in Spain, especially in recent years, position heart transplant as the treatment of choice in irreversible heart failure patients without other established medical or surgical options.