Transplant, shock, heart failure.

H. Puerta de Hierro is a pioneering centre for heart transplantation (HTx) in our country. More than 910 HTx have been performed here, making this centre the Spanish hospital with the highest number performed to date. It is also the centre in our country where the most ventricular assist devices (artificial hearts) have been implanted. The group's core research work has to date focused precisely on the clinical aspects arising from the large cohort of patients followed up, whether pre-HTx (heart failure) or followed after HTx.

The group is thus a national and international reference in certain aspects related to immunosuppression and the complications experienced by patients undergoing heart transplantation (Alonso-Pulpón, et al. Cardiac transplantation: organizational aspects and current trends in immunosuppression. A view from Spain. Heart 2012; 98:878-89). Our group is particularly active in the study of two conditions: primary graft failure (PGF) and cardiac allograft vasculopathy (CAV). Both conditions are the main causes of death in HTx patients, either in the first month post-HTx (PGF) or beyond the first year (CAV). Our group has led an independent clinical trial (EVEROSTAT) focused on studying a drug for the treatment of CAV, the results of which were recently presented as a late breaking trial at the Congress of the International Society for Heart and Lung Transplantation (ISHLT). It has also recently published a paper developing a predictive algorithm for PGF, to be followed in 2013 by the paper establishing its international validation. Both lines of work (PGF and CAV) are leading to top-level publications in the field of HTx (Segovia J, et al. J Heart Lung Transp 2011;30:644-51; Gonzalez-Vilchez J, et al. J Heart Lung Transplant. 2012 Mar;31(3):288-95)

Other important lines of development in recent years have been:
- Diagnosis and treatment of AL cardiac amyloidosis, in collaboration with the centre's Haematology group, led by Dr Krsnik. Two main publications:
I. Sayago,…J. Segovia: J. Heart Lung Transplant 2015
I. Krsnk, …J. Segovia: Rev Clin Esp 2013
- Study on Pulmonary Hypertension in patients with myelofibrosis due to myeloproliferative syndromes, in collaboration with the centre's Haematology group, led by Dr Ojeda. Publication currently in press.
- Early detection, characterisation and early treatment of cardiogenic shock based on a multidisciplinary cardiogenic shock unit using circulatory support devices. In collaboration with cardiac surgery and anaesthesia departments. Paper submitted to Rev Esp Cardiol.