Methods: Between March 1998 and September 2012, 172 patients (135 males, 37 females; mean age 39.7±14.6 years; range 5 to 65 years) who underwent heart transplantation in our clinic were retrospectively reviewed. The patients were divided into two groups according to the graft ischemic time, including being equal or over 200 minutes (group 1) and under 200 minutes (group 2). The possible relationship between donor ischemic time and mortality was investigated during the early, mid, and long-term follow-up period.

Results: The mean donor age and follow-up were 29.9±11.8 years, and 1,295.0±1,249.1 days, respectively. The mean overall donor ischemic time was 181.7±61.2 min with 244.0±36.9 min in group 1 and 139.0±30.1 min in group 2. Although group 1 had higher intraoperative mortality rates (p=0.048), there was no statistical significance in postoperative mortality between two study groups. Each study group was divided into three subgroups with respect of donor age (≤25 years, 26-39 years, and ≥40 years) and no statistically significant difference was found in overall mortality rates among six study subgroups (p=0.307).

Conclusion: Improvements in myocardial protection and perioperative management procedures lead to increased survival rates in patients with heart transplantation. Donor heart preservation, operation procedures and the preoperative status of the recipients are considered more important risk factors on mortality after heart transplantation than donor ischemic time alone.