Five-year evaluation of the first heart transplant program in a European ultraperipheral region: characteristics, outcomes and implications
Bibliographic record
Abstract
Abstract Background In November 2019, the first heart transplant (HT) Program in a European ultraperipheral region was established following a Hub and Spoke model recommended by the European Society of Cardiology. This marked a significant milestone in transplant activity, that had to overcome numerous challenges given its geographical location and multi-insularity. Objectives To analyze the characteristics, outcomes and implications of a novel five-year HT program in an outermost region. Methods A retrospective analysis was conducted on patients who underwent HT between November 2019 and December 2024. Clinical, surgical, and follow-up data were retrieved retrospectively from the Heart Transplant Registry and a survival analysis was performed using Kaplan-Meier curve. Results A total of 98 HT were performed using bicaval technique (one in December 2019, 15 in 2020, 17 in 2021, 22 in 2022, 21 in 2023, and 22 in 2024). Recipients had a mean age was of 55.3 ± 10.8, 19.4% female, and 44.9% had non-ischemic dilated cardiomyopathy. A low percentage of procedures were urgent (7%), and the intra-aortic balloon pump was the most used ventricular assist device (9.2%). The median time on waitlist CT was 58 days (IQR 6-86). Two and one donors were generated in Murcia and Madrid respectively, while 98% were local donors (figure 1A). Mean age of donors was 47.1 ± 12.9 years and 85.7% were male. Mean ischemia time was 151.7 ± 47.8 and, 20.4% were donors from controlled donation after circulatory death. The one-year and two-year survival rate were 93.6% and 87.9% respectively (figure 1B). Conclusions The first and only HT program in a European ultraperipheral region has overcome the geographical and logistical challenges it presented, demonstrating self-sufficiency, excellent coordination and favorable survival outcomes. This HT program could serve as an example for other regions with similar characteristics to ours. However, we should await long-term outcomes, and its broader applicabilily should be evaluated.Origin of HT recipients/donors. Survival
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".