Distance between Recipients Residency and Heart Transplant Center: Effect on Long-Term Outcome

• Published in: The Journal of heart and lung transplantation Vol. 40; no. 4; p. S257
• Main Authors: Lechiancole, A., Ferrara, V., Sponga, S., Vendramin, I., Guzzi, G., Nalli, C., Di Nora, C., Daniela, P., Livi, U.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2021
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2021.01.733

The distance of recipients residency from the heart transplant (HT) Center could condition the treatment received, and thus long-term results. Aim of the study was to verify the impact of the distance from our Center on long-term outcome after HT. Adult patients receiving HT at our Centre since 1985 were enrolled. Patients supported with ECMO, VAD, high inotropic support or mechanical ventilation at the time of HT were excluded. Patients were divided in two groups according to the distance from our Center: Northern area (NA, ≤200 mi) and Centre-Southern area (CSA, >200 mi). Baseline recipients and donors characteristics are shown in Table 1. During a median follow up of 90 and 82 months (p=0.59) for NA and CSA groups, survival was worse for patients closest to the HT Center, p=0.02 (Fig 1). Compared to CSA group, NA patients were more frequently affected by neoplasia (p=0.03), and less by ≥grade 2 rejection (p=0.03), with no differences among the incidence of infections and CAV. There were no differences in immunosuppressive and other medical therapy at 1,5 and 10 years after HT. However, NA group showed higher median creatinine level at 5-year follow-up (p=0.03) and higher median cholesterol level at both 5 (p<0.01) and 10-year follow-up (p=0.04). The distance of recipient residency from the HT Center seems not to negatively affect the outcome after HT. Indeed other factors, probably related to genetic and lifestyle characteristics, that typically differ in the two Italian areas considered, could have influenced the observed results. Further in-depth prospective studies are required to confirm this hypothesis.