First cardiac transplant program in a european ultraperipheral and multi-insular region. The advantage of disadvantage

Abstract

Background: The establishment of a new cardiac transplant (CT) in a remote andmulti-island population presents significant clinical and logistical challenges. A newSpanish HT program was initiated in the Canary Islands, Spain, in November 2019.Objectives: To analyze the characteristics and early-term outcomes of a novel CTprogram with specific particularities.Methods: Retrospective, single-center, observational study, of all consecutive adultpatients who underwent CT between November 2019 and July 2023. Clinical,surgical, and follow-up data were retrieved retrospectively from the Spanish HeartTransplant Registry and local database.Results: Seventy de novo CT were performed by our team using bicaval technique(one in December 2019, 15 in 2020, 17 in 2021, 22 in 2022, and 15 until July2023). Recipients had a mean age of 56 years (25-71), 22% were female, and 37%had ischemic dilated cardiomyopathy. Two donors were from Murcia and one fromMadrid, and the rest (96%) were local donors (figure 1). Mean age of donors was45 years and 74% were male. The mean ischemia time was 151 min (70-298) and10 (14%) CT were from controlled donation after circulatory death. The averagerecipients 30 days and 1 -year survival rate was of 95.7% and 94.1% respectively,with a median follow up of 19 months (figure 2).Conclusions: Despite the challenges posed by the extreme isolation andmulti-island geography, the CT program has demonstrated self-sufficiency, excellentcoordination, and promising early-term survival results.Origin of recipients and donors.