Conditional Survival in Heart Transplantation: An OPTN Database Analysis.

ABSTRACT Background Survival following heart transplant is typically reported only in terms of overall survival. Conditional survival (CS) may provide prognostic information for patients after surviving a given period. This study sought to provide an analysis of CS in heart transplantation. Methods Data from 29,000 patients who underwent heart transplantation between 2002-2016 were analyzed from the Organ Procurement and Transplantation Network database. Five-year conditional survival rates were calculated according to age, sex, race, renal function, and hepatic function at transplantation. Results As time from transplantation increased from 0 to 5 years, the 5-year observed CS changed from 74% to 82% for ages 60 at transplantation. CS peaked at 1 and 2 years after transplantation for most subgroups. In recipients under 40 years, men had slightly higher CS than women (absolute difference 3-4%). In recipients over 60 years, women had slightly higher CS (absolute difference 1-4%). Black recipients had lower survival than white and hispanic for nearly all time points. Recipients under 40 years with the worst renal (65% to 88%) and hepatic function (66% to 83%) at transplantation experienced the largest increase in CS. Conclusions The conditional survival of patients who undergo heart transplantation changes substantially over time. The largest increases in CS are in young patients with impaired renal and hepatic function. CS can provide more accurate prognostic information for heart recipients who survive a given period after transplantation.