Survival in Adult Patients Undergoing Heart Transplantation 1995–2024: A Report of the RETRAC Registry

Background: Heart transplantation (HT) remains the definitive treatment for advanced heart failure that is refractory to both medical and invasive therapies. Although global registries offer extensive data on survival outcomes, there is a relative paucity of information regarding HT outcomes in Latin America (LATAM), particularly in Colombia. Methods: This study analyzed adult patients who underwent HT between 1995 and 2024, using data obtained from an institutional HT registry (RETRAC) in Cali, Colombia. Survival outcomes were evaluated using Kaplan-Meier curves and Cox proportional hazards models. Results: We included 260 patients who underwent HT in this 29-year cohort from a LATAM country. The median age at transplantation was 51 years, and 77.7% were male. The primary etiologies were idiopathic/dilated cardiomyopathy (IDC) (41.3%), ischemic cardiomyopathy (IC) (27.0%), and valvular heart disease (VHC) (9.7%). The most prevalent comorbidities were hypertension (HTN) (48.3%), diabetes mellitus (DM) (18.9%), and chronic kidney disease (CKD) (13.1%). The overall median survival following HT was 7.4 years. One-year survival was 74.6% (n = 194), five-year survival was 56.9% (n = 147), and ten-year survival was 46.9% (n = 122). Survival differed significantly by age and sex, with patients aged