When I first got to OEF in Jan 2002, they couldn't use OH-58s or D model AH64s. (My understanding is that they do now, but only in the southern areas where the elevation is low.)
The 47 has a ton of power, but high and hot affects it just like any other helicopter. We routinely operated at max gross weight in 8 - 12000 ft mountains. Sometimes after doing performance planning we discovered that on certain days we couldn't load up to our max gross of 50,000 lbs. and were maybe limited to 48 or 49 k.
There was also a time when the lead ship in our flight of two couldn't quite make it over a mountain peak without chucking some MREs off the ramp.
But the 47 is amazing... we flew 55-60 fully loaded troopers per bird in and out of the Sherkankil Valley during Operation Anaconda into LZs with elevations around 8 - 10k. (We have seats for 33, but just load the troops like cordwood on the floor when we have to.).
OIF really wasn't an issue. We did a lot more slingload ops there... carried a whole bunch of crap between Kuwait and Iraq and usually had to depend on the engine torque readout to "weigh the load." After flying some very, very heavy mobile HQ containers for the Division Commander from Kuwait to Mosul, we were accused of over-loading our aircraft to 55k instead of 50. Nobody could give us a straight answer on what those containers weighed, but when I picked one up my engine torque told me I was right at 50k.
And unfortunately, a 64, 58, or 60 can't keep up with a 47, no matter the temp or altitude.