RT Journal Article SR Electronic T1 Changes in patient characteristics following cardiac transplantation: the Montreal Heart Institute experience JF Canadian Journal of Surgery JO CAN J SURG FD Canadian Medical Association SP 305 OP 310 DO 10.1503/cjs.005716 VO 60 IS 5 A1 Nicola Vistarini A1 Anthony Nguyen A1 Michel White A1 Normand Racine A1 Louis P. Perrault A1 Anique Ducharme A1 Denis Bouchard A1 Philippe Demers A1 Michel Pellerin A1 Yoan Lamarche A1 Ismaïl El-Hamamsy A1 Geneviève Giraldeau A1 Guy Pelletier A1 Michel Carrier YR 2017 UL http://canjsurg.ca/content/60/5/305.abstract AB Background: Heart transplantation is no longer considered an experimental operation, but rather a standard treatment; nevertheless the context has changed substantially in recent years owing to donor shortage. The aim of this study was to review the heart transplant experience focusing on very long-term survival (≥ 20 years) and to compare the initial results with the current era.Methods: From April 1983 through April 1995, 156 consecutive patients underwent heart transplantation. Patients who survived 20 years or longer (group 1) were compared with patients who died within 20 years after surgery (group 2). To compare patient characteristics with the current era, we evaluated our recent 5-year experience (group 3; patients who underwent transplantation between 2010 and 2015), focusing on differences in terms of donor and recipient characteristics.Results: Group 1 (n = 46, 30%) included younger patients (38 ± 11 v. 48 ± 8 yr, p = 0.001), a higher proportion of female recipients (28% v. 8%, p = 0.001) and a lower prevalence of ischemic heart disease (42% v. 65%, p = 0.001) than group 2 (n = 110, 70%). Patients in group 3 (n = 54) were older (52 ± 12 v. 38 ± 11 yr, p = 0.001), sicker (rate of hospital admission at transplantation 48% v. 20%, p = 0.001) and transplanted with organs from older donors (42 ± 15 v. 29 ± 11 yr, p = 0.001) than those in group 1.Conclusion: Very long-term survival (≥ 20 yr) was observed in 30% of patients transplanted during the first decade of our experience. This outcome will be difficult to duplicate in the current era considering our present population of older and sicker patients transplanted with organs from older donors.