Ann Thorac Surg 1997;64:1668
© 1997 The Society of Thoracic Surgeons
Discussion
Discussion
See also page 1661.
DR JAMES K. KIRKLIN (Birmingham, AL): We are all indebted to Dr Hetzer and his colleagues in Berlin and Hannover for their ongoing and important contributions to the treatment of end-stage heart disease.
This is a large group of patients that has survived the trials and tribulations of the first 9 years and therefore, obviously is selected in some way. Could you comment on any of the factors that might have selected these patients out for long-term survival with the goal of helping us in the future select those patients who should be subjected to transplantation versus other therapies for end-stage heart disease?
DR HETZER: I think this is the most important question that is raised from such long-term studies. I cannot give you a precise answer as we are in the process of looking into all the data that might have an influence on early death or might influence long-term survival. However, very similar to a study published 2 years ago by the Stanford group, it seems that, for instance, patients who have cytomegalovirus infections and patients who are in a lower age group, as we have shown, may have a longer survival. But I think only very intensive data analyses can finally answer these questions. Certainly, this is very important. I think we should now focus more on the questions of why patients live long instead of what we have up to now been looking at, mostly why patients die early.
Related Article
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Status of Patients Presently Living 9 to 13 Years After Orthotopic Heart Transplantation
- Roland Hetzer, Wolfgang Albert, Manfred Hummel, Miralem Pasic, Matthias Loebe, Henning Warnecke, Axel Haverich, and Hans Georg Borst
Ann. Thorac. Surg. 1997 64: 1661-1668.
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