Authors (including presenting author) :
Au WKT, Suen WSA, Ho KLC, Chan TLD, Rocha BA, Sit KY, Hsin KYM, Lee OJ, Bhatia I
Introduction :
It’s been about 25 years since the first heart /lung transplant was performed in Hong Kong and it has grown since then. To evaluate and compare transplantation performance at the international level, with the aim of improving the quality and safety of the care we provide to our patients, we submit our transplant data to the International Society for Heart and Lung Transplantation (ISHLT) Registry. The registry represents approximately 75% of worldwide transplant activity.
Objectives :
Analysis of registry data provides an overall perspective of this important clinical activity that enables detection of potential shortcomings, and also highlights the areas for improvement. The present article reports the results of heart/lung transplants in Hong Kong since this therapeutic modality was started.
Methodology :
The Registry requires submission of core donor, recipient, and transplant procedure variables at baseline and at a yearly follow-up
Result & Outcome :
To this date, 211 heart (1, re-transplant) and 70 lung (7, single lung and 63, double lung) and 4 heart-lung transplants have been performed. During the last few years, transplant activity has remained steady, with approximately 14 heart and 10 lung transplants/year. All heart transplantation are performed by the orthotopic technique. Single‐lung transplant is performed via posterolateral thoracotomy, while bilateral sequential double‐lung transplant is performed via transverse anterior thoracosternotomy (clam‐shell incision), with cardiopulmonary bypass being used only when necessary. Ventricular assist devices (VAD), which provide mechanical circulatory support, have been available since 2010 and serve as a bridge to transplant. Before 2010 intra-aortic balloon counterpulsation was used as the bridge to transplantation. Survival rate of our lung transplantation at 1, 5, 10, 19 years is 86.5%, 64.6%, 54.6%, 45.5% vs. 80.7%, 55%, 33%, 12.4% respectively reported in the ISHLT. Survival rate of heart transplantation at 1, 5, 10, 20 years is 86.9%, 79.9%, 58.4%, 42.8% vs. 82.4%,70.2%,53.8%, 22.3% in ISHLT database. Our heart and lung transplantation outcomes compare favourably and have even exceeded international standards. Pre-heart transplant clinical stabilization with VAD’s has been in use.In addition to measuring our progress against the whole field of transplantation, joining the ISHLT registry has provided us with a marvellous opportunity to participate in outcomes research about these advanced cardiac surgeries, and enabled the international community to recognize this activity in Hong Kong.
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