Risk of death or incapacitation after heart transplantation, with particular reference to pilots.

Academic Article


  • Pilots who have received a heart transplant may subsequently want to resume flying. This study was undertaken to determine whether a group of heart transplant recipients who had a particularly low risk of sudden unexpected death could be identified from clinical data. An event, "rapid-onset death," was defined incorporating a number of possible causes of death that could result in a heart transplant recipient-pilot losing control of an airplane. The survival of 3676 patients undergoing a first heart transplantation was 85% and 73% at 1 and 5 years, respectively, the hazard function having a high early phase of risk. When time zero was moved to the beginning of the second year after transplantation, the freedom from "rapid-onset death" at posttransplantation year 2 and posttransplantation year 5 was 96.8% and 88%, respectively. For patients who had both a "normal" coronary angiogram and no episodes of acute heart rejection during the first year transplantation, the probability of "rapid onset death" during the second posttransplantation year was 1.4%, and given the same circumstances, during the third posttransplantation year the risk of "rapid-onset death" was 1.6%. This information is potentially useful to the Federal Aviation Administration for policy decisions regarding this issue.
  • Authors

    Published In


  • Adolescent, Adult, Aged, Aircraft, Cause of Death, Databases, Factual, Death, Sudden, Cardiac, Disability Evaluation, Graft Rejection, Heart Transplantation, Humans, Male, Middle Aged, Occupational Diseases, Postoperative Complications, Proportional Hazards Models, Risk, Survival Rate, Work Capacity Evaluation
  • Author List

  • McGiffin DC; Naftel DC; Spann JL; Kirklin JK; Young JB; Bourge RC; Mills RM
  • Start Page

  • 497
  • End Page

  • 504
  • Volume

  • 17
  • Issue

  • 5