Current Status of Heart Transplantation in Taiwan S.-S. Wang, C.-H. Wang, N.-K. Chou, N.-H. Chi, S.-C. Huang, H.-Y. Yu, I.-H. Wu, Y.-S. Chen, W.-J. Ko, C.-I. Tsao, C.-T. Shun, and S.-H. Chu ABSTRACT Purpose. We reviewed the national results of heart transplantation in Taiwan. Methods. From July 1987 to December 2012, 1354 patients underwent heart transplantation in 18 qualified heart centers in Taiwan. The transplantation volume and survival rate were reviewed. Results. The median age of recipients was 49 years at surgery, with 37% in the International Society for Heart and Lung Transplantation (ISHLT)-1A, 30% in ISHLT-1B, and 32% in ISHLT-2. The allograft 1-, 3-, 5-, and 10-year survival rates were 78%, 68%, 61%, and 47%, respectively. Mostly difficult recipients were bridged by extracorporeal membrane oxygenation (ECMO) instead of ventricular assist device (VAD). Conclusion. The results of heart transplantation in Taiwan are comparable with ISHLT world results. In Taiwan, we use more ECMO than VAD for mechanical circulatory support to bridge critical recipients to heart transplantation.

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N TAIWAN, we had a very early achievement in the field of transplantation medicine compared with other Asian countries. On May 27, 1968, Professor Lee led the transplantation team at National Taiwan University Hospital (NTUH) in performing the first living-donor renal transplantation in Asia, and then the first cadaver renal transplantation the next year. On July 17, 1987 Professor Chu led us to perform the first successful heart transplantation in Taiwan at NTUH. In this study, we reviewed the current status of heart transplantation in Taiwan. PATIENTS AND METHODS From July 1987 to December 2012, 1354 patients have undergone heart transplantation in Taiwan (Fig 1). Now there are 18 qualified heart transplantation centers [1]: geographically 8 centers in North Taiwan, 4 in Middle Taiwan, 5 in South Taiwan, and only 1 in East Taiwan. According to the reports of the Taiwan Organ Registry and Sharing Center (TORSC) and the Bureau of National Health Insurance (NHI), more than 90% of transplantations were centralized in North Taiwan, because all of the top 5 heart transplantation centers are located in the Taipei metropolitan area (Fig 2). The indications for heart transplantation in Taiwan are as follows: (1) congestive heart failure with maximal VO2