Abstract
The aim of this study is to provide a description of patients on the waiting list
for heart transplants in Germany; the focus is on comparing the era after implementation
of the new transplant law with the former era. This study used data from the Eurotransplant
registry. The population consisted of all patients who registered for heart transplantation
in Germany between January 1990 and May 2009. Patients were followed up to the earliest
of the following events: heart transplantation, death, or end of the observation period.
The actual mortality rates were calculated using a competing risk methodology. The
proportion of patients on the waiting list aged 65 years or older has increased from
1.9 % in 1990 to 8.3 % in 1997, 7.8 % in 2000 and 12.6 % on December 31, 2008. The
1-year waiting list mortality rate, expressed as the proportion of patients who die
within 1 year after being listed for heart transplantation decreased in the period
2001–2009 compared to the period 1991–2000. Patients registered in the period from
1991–2000 had a 25.9 % chance of dying prior to heart transplantation compared to
18.9 % for patients who were registered in the years 2001–2009. In the registration
period 1981–1990, a transplant candidate had a 64.3 % chance of undergoing heart transplantation
within the first year after being listed, while for patients who were registered in
the period 2001–2009 this probability has been reduced to 40.2 %. Despite the fact
that patient profiles have worsened and access to transplantation decreased, mortality
rates of patients on the heart transplant waiting list have decreased. These data
show that treatment of patients with advanced heart disease has improved in Germany.
Key words
heart and lung transplantation - heart disease - cardiomyopathy
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Jacqueline Mathilde Smits, MD, PhD
Eurotransplant
PO Box 2304
2301 CH Leiden
Netherlands
Email: jsmits@eurotransplant.nl
