Progress in Heart Transplantation in Brazil: is it Time to Build a National Database?

Heart transplantation (HT) is the therapy of choice for advanced heart failure. Survival has greatly improved since the first heart transplant 50 years ago, especially after the introduction of calcineurin inhibitors and better management of complications related to immunosuppression. In Latin America, Brazil is renowned for the high number of HTs performed annually. Despite its importance, reports on survival, immunosuppression and complications of HT are scarce in Brazil.

A retrospective open cohort of HT in Brazil is presented in this issue of Arquivos Brasileiros de Cardiologia. The article shows important data regarding epidemiology, survival and complications of HT recipients between 2000 and 2015. Median survival in this cohort was 8.3 years, and one- and 5-year survival rates were 70.9% and 59.5%, respectively. These results are better than those from 1984 to 1999, when the one- and 6-year survival rates were 66% and 54% respectively, suggesting improvement in post-transplant care. However, this median survival is lower than 12.2-year survival and one- and 5-year survival of 81% and 69% reported by the International Society of Heart and Lung Transplantation (ISHLT), probably due to sociodemographic and economic differences between Brazil and developed countries.

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