Spanish heart transplant registry. 36th official report of the Heart Failure Association of the Spanish Society of Cardiology

Abstract

Introduction and objectives: This report presents updated data on heart transplants in Spain, including procedures carried out in 2024. It reviews trends over the past decade (2015-2024) in donor and recipient characteristics, surgical techniques, immunosuppression strategies, and survival rates.

Methods: Data were drawn from the Spanish heart transplant registry, which is updated annually. The analysis includes 347 transplants performed in 2024, as well as procedures from 2015 to 2023 (n=2721).

Results: In 2024, the number of heart transplants increased by 6.8% compared with 2023. There were no significant changes in recipient age or sex, but the proportion of urgent transplants rose to 47.0%. Use of circulatory support devices increased, particularly extracorporeal membrane oxygenation. The average donor age showed a slight increase in 2024, although the long-term trend remained downward. Donation after circulatory death accounted for 29.1% of transplants in 2024. One-year survival rates improved, reaching 85.2% for transplants performed between 2021 and 2023.

Conclusions: The number of heart transplants continued to grow, nearing historic highs, largely due to the expansion of donation after circulatory death. Improved 1-year survival reflects the maturity of transplant programs, advances in surgical and medical management, and better pretransplant conditions in recipients.

Keywords: Análisis de supervivencia; Heart transplantation; Registro; Registry; Survival analysis; Trasplante de corazón.