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Introduction Heart transplantation is the treatment indicated for patients with advanced and refractory heart failure (HF). The transplant is expected to increase survival and improve the level of health-related quality of life (HRQoL). The aim of this study was to compare the level of HRQoL, as well as social and clinical variables, between patients with advanced HF and heart transplant (HT) recipients. Methods This is a cross-sectional study, conducted at a Brazilian university hospital, during outpatient consultations. The level of HRQoL was assessed using the World Health Organization Quality of Life-Bref questionnaire. Descriptive statistics were used to analyze the data, and the comparison of the level of HRQoL was performed using the Mann-Whitney U test. Results Two hundred sixty-two patients participated in the study. Seventy-nine of them had advanced-stage HF and 183 were HT recipients. Compared to patients with advanced HF, HT recipients had a better level of HRQoL, were less frequently absent from work due to health problems, had higher income, used a higher number of medications, and there was a higher percentage of retirees among them ( P -value < 0.001). Conclusion In every comparison, HT recipients showed a better level of HRQoL than patients with advanced HF, along with less absence from work and higher income. These results suggest that heart transplantation can improve HRQoL and survival of patients with advanced HF.

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Background Heart transplant (HT) is an alternative for patients with advanced heart failure (HF). Social inequalities may influence survival, but are still not well understood. The aim of this study was to assess the impact of social and clinical inequalities on the survival of HT recipients. Methods Retrospective cohort study conducted at a Brazilian hospital from 2006 to 2018. Results Three hundred and two patients were analyzed. Most HT recipients were male (205, 67.9%), mixed race 146 (48.3%), retired (166, 56.5%), median age 47 (38‐57) years, and had studied no more than eight years (191, 65.8%), were younger than 60 years old (256, 84.7%). 149 (51.7%) had per capita monthly income inferior to one Brazilian minimum wage, equivalent to US$250. 123 (95.4%) out of 129 patients had allograft cellular rejection 2R or 3R. Median donor age was 32 (23‐39) years. The overall survival was 76.6%, 62.2%, and 58.2%, at 1, 5, and 10 years, respectively. Age <60 years old and higher income were associated with a greater chance of survival (p‐values .009 and <.001, respectively). Conclusion Younger age and higher per capita income had positive impact on HT recipient survival. The level of education did not affect survival in this cohort.