[Spanish Heart Transplantation Registry. 17th official report of the Spanish Society of Cardiology Working Group on Heart Failure, Heart Transplantation, and Associated Therapies (1984-2005)].

INTRODUCTION AND METHODS: This article summarizes the general characteristics of heart transplantation in Spain and the results achieved, once data for 2005 have been included.

RESULTS: In the course of the last year, 287 heart transplantations were performed, which brings the total to 4967 since 1984. Clinically, the typical Spanish heart transplant patient is male, aged about 50 years, has blood group A or O, has non-revascularizable coronary disease or idiopathic dilated cardiomyopathy, and is in New York Heart Association functional class IV/IV. The percentage of emergency heart transplants carried out was 22%, which is considerably lower than in the previous year (i.e., 35%) and slightly lower than the average for the last 5 years (i.e., 23%). The early mortality rate was 10%, which is similar to that in the previous year and lower than the average for the last 5 years (i.e., 12%). After adding the 2005 results to those of previous years, the survival probabilities at 1, 5, and 10 years were 75%, 65%, and 50%, respectively. On calculating survival curves for separate historical periods, a significant improvement could be seen for the last 5 years, in which the 1- and 5-year survival probabilities were 80% and 70%, respectively. The most frequent cause of death in the first month was acute graft failure; in the first year, infection and rejection were most common; and, in the long term, tumors and the combination of graft vascular disease with sudden death.

CONCLUSIONS: Comparative analysis of survival rates showed that short-, medium-and long-term outcomes in Spain are consistent with those reported in the world literature, including a continuing trend towards better survival over the years.