Outcome of heart transplantations done in our centre.

Background: We have found no study conducted economic issues on patient outcomes after heart transplantation (HTx) in China for further development.

Material/methods: From May 2004 to February 2006, there were 10 transplants performed in 9 male patients in our center: 1 heart lung recipient and 8 heart recipient. Among them, 7 lacked health insurance and 2 had insurance.

Results: Their ages were between 24 years and 43 years (mean 39 years). The number of hospitalizations, number of days in hospital per admission, number of emergency room visits and mean left ventricular ejection fraction (LVEF) in the year before operation were 5.5, 54, 8.1 and 0.19 respectively. After operation, these figures decreased significantly to 1.7 (P<0.05), 18 (P<0.05), 1.1 (P<0.05) and 0.70 (P<0.05) respectively. During the follow up of 370~930d, one of the 9 patients who lacked health insurance died of acute rejection due to stopping mycophenolate mofetil (MMF) 7 months after operation and the heart lung recipient who also lacked health insurance died of pulmonary infection 1 year later. All patients who lacked health insurance experience emotional distress.

Conclusions: HTx is a good treatment for selected patients with end-stage heart failure (ESHF) and future research is to be expected in the fields of insurance coverage to improve the quality of life and the Chinese transplant group should be commended for their courageous work in the treatment of end stage heart disease under challenging circumstances.