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Heart transplant (HT) remain a gold standard therapy for patient with ESHD. Other obstacles than organ shortage are identified in our study, reporting 30 years outcome Between 1989 and 2019, 341 patients underwent HT. Due to missing, 70 patients were excluded. Mean age of our recipient is 35 ±15 years, 74.7% male. Causes were Dilated cardiomyopathy 62.7% while 23.2% ischemic cardiomyopathy and restrictive cardiomyopathy 4%. Mean time on waiting list was 98 days.17.5% of our cohort were in INTERMACS 1 and 2 classes, where 24.3% were in class 3. Mechanical circulatory support (temporary or long term) was used in 14.7% of the patients before transplant. Pre-operative renal and hepatic impairment were found in 24% and 5% respectively Mean ischemic time was 185 minutes.10% of our recipients required short term mechanical support post-operatively. Early mortality happened in 14%. post-operative stroke was diagnosed in 4.7% of the patients. Long term survival of discharged patient is 86% in the follow up. Comparing first intraoperative Echocardiography with last follow up Echocardiography showing normal LV function in 72% while in follow up 63.5% are having normal LV function. Moreover, for right ventricle only 14.7% were having normal RV function and 8.4% were having sever RV dysfunction at first post-op Echo, however in last follow up normal RV function was found in 43% while sever RV dysfunction was found in only 3% Despite the high-risk patient profile, we have observed acceptable outcome. Dramatic improvement in the RV function was observed in long-term follow-up [ABSTRACT FROM AUTHOR]

Cardiac transplants are performed sporadically or not at all in the majority of predominantly Muslim countries in the Middle East. We examined our experience in 76 patients who underwent heart transplantation between January 2005 and May 2010 in our center in Saudi Arabia. Excluded were 50 transplants performed between 1989 and 2004, due to incomplete data. Primary outcomes were complications, 30-day and late mortality rates, and 1-year survival. The heart transplant activity between 2005 and 2010 (15.0 per year) was 4.5-fold higher than that between 1989 and 2004 (3.3 per year). There were 61 (80%) men and 15 (20%) women, with a mean age of 35 years (range, 13-57 years). The mean waiting list time was 64 days (range, 1-262 days), and hospital stay was 30 days (range, 12-166 days). Major complications were infection (10), low-grade rejection (9), reoperation for hemorrhage (8), and sternal dehiscence (2). The 30-day mortality was 7.8% (6/76). Actuarial survival was 87.4% at 1 year and 81.5% at 3 years. A hospital in a Muslim country can increase cardiac transplant activity with excellent 30-day mortality and early survival comparable to that in worldwide counterparts.