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by momenti 1570 days ago
Heart transplant recipients survive 15 years on average: https://en.wikipedia.org/wiki/Heart_transplantation
3 comments

The Wikipedia page cites a documentary as the source, which may be correct, but doesn't seem like an appropriate source. Here's a paper that I skimmed the abstract of claiming ~9 years:

https://pubmed.ncbi.nlm.nih.gov/15280687/

I don't know what the documentary source is, but this paper is from 2004, and it's likely that procedures have improved reliability since then.
Documentary cited is from 2007 so that's a marked improvement for 2-3 years...

I'd personally lean towards trusting published medical journal.

Here's a 2015 article from the Journal of Thoratic Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387387/.It doesn't calculate the exact average, but 21% of patients are alive after 20 years. Survival rates have definitely rapidly increased over the last two decades.

> Survival after heart transplantation is excellent, particularly if it is compared with the natural course of end-stage HF. The most recent data of the registry of the International Society of Heart and Lung Transplantation indicates a current 1-year survival of 84.5% and a 5-year survival of 72.5% (5). This has significantly improved as compared to the 76.9% 1-year survival and 62.7% 5-year survival in the 1980s. The development of new immunosuppressive drugs which allow a variety of immunosuppressive regimens, tailored to the individual patient, has contributed to this success, since rejection and the adverse effects of immunosuppression could be better controlled. After 20 years, ca. 21% of patients are still alive, according to the international registry (5). In some experienced centers, long-term survival is reported to be even higher (6-9). The University Hospital Zurich has achieved a 20-year survival rate of 55.6% (10).

>The improvement in outcome over the decades is related mainly to an increase in survival over the first year. After this period, the attrition rate of ca. 3-4% per year has remained similar over the different eras. This might be attributable to the fact that it was not possible to reduce the incidence of long-term complications after heart transplantation, such as chronic allograft vasculopathy (CAV) and malignancies, which account for ca. 35% of all deaths after 10 to 15 years (5).

To be honest, not sure why we spend so much resources on heart transplants. For the most part, the underlying condition that wrecked your old heart is probably still there. We should be putting more resources into preventative medicine.
Preventative medicine is well understood and widely available. People just aren't interested or unresponsive to treatment.
This. I know a doctor who was heading the liver transplant list. Patients would come in, be diagnosed and told they need to live healthier, do this and do that as part of the preventative measures. Clear medical advice. Habitual change is the hardest in my view and this is also how this story continues. Over the course of time these patients will visit regularly. Their condition is worsening and the preventative medical advice will be stronger and more urgent. In the end most still end in the transplant list. Most having exhibited little effort to turn their life around.
When it becomes evident that "clear medical advice" isn't working, then maybe we should dig another level deeper and find out WHY it isn't working. Shifting the blame to the patients when you have most that are failing is, in my opinion, bad medicine.
At some point an issue is no longer a medical problem with medical solutions.

For example, drunk driving or shootings aren't medical problems, but cause them

Is that mean or median? And is it after taking out outliers (like people who pass away within a week or before they're discharged)?