Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1987 Jun;205(6):719–726. doi: 10.1097/00000658-198706000-00014

A successful cardiac transplantation program using combined university and community resources.

L A Gray Jr, A D Slater, J B Klein
PMCID: PMC1493080  PMID: 3296972

Abstract

From August 1984 to August 1986, 75 patients with end-stage heart disease and cardiac failure were evaluated. Twenty-five patients received orthotopic cardiac transplants from donors as far away as 1300 miles with an ischemic time of less than 4 hours. Seventeen of 25 patients are alive 3-24 months after transplantation. Evidence of rejection was seen in each patient. Twelve patients had mild, easily controlled rejection; 13 patients had severe rejection averaging 3.1 episodes per patient. The initial immunosuppressive regimen included cyclosporine and prednisone. To decrease complications related to high dose steroids, azathioprine has recently been added to our maintenance regimen to lessen steroid requirements. Acute rejection episodes were treated with 500-1000 mg of methylprednisolone for 3 days; antithymocyte globulin or the murine monoclonal antibody, OKT3, was added for severe or resistant rejection episodes. Three patients died of rejection, and two patients died of infection. Seventeen of 18 survivors are New York Heart Association (NYHA) Class I; 15 patients have returned to employment or full activity. Because of new developments in support of transplant candidates and treatment of complications, as well as the introduction of cyclosporine, orthotopic cardiac transplantation has become an effective treatment for end-stage heart disease.

Full text

PDF
719

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Annas G. J. No cheers for temporary artificial hearts. Hastings Cent Rep. 1985 Oct;15(5):27–28. [PubMed] [Google Scholar]
  2. Barnard C. N. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town. S Afr Med J. 1967 Dec 30;41(48):1271–1274. [PubMed] [Google Scholar]
  3. Baumgartner W. A., Reitz B. A., Oyer P. E., Stinson E. B., Shumway N. E. Cardiac homotransplantation. Curr Probl Surg. 1979 Sep;16(9):1–61. doi: 10.1016/s0011-3840(79)80010-6. [DOI] [PubMed] [Google Scholar]
  4. Baumgartner W. A., Reitz B. A., Oyer P. E., Stinson E. B., Shumway N. E. Cardiac homotransplantation. Curr Probl Surg. 1979 Sep;16(9):1–61. doi: 10.1016/s0011-3840(79)80010-6. [DOI] [PubMed] [Google Scholar]
  5. Caves P. K., Stinson E. B., Billingham M., Shumway N. E. Percutaneous transvenous endomyocardial biopsy in human heart recipients. Experience with a new technique. Ann Thorac Surg. 1973 Oct;16(4):325–336. doi: 10.1016/s0003-4975(10)65002-3. [DOI] [PubMed] [Google Scholar]
  6. Copeland J. G., Mammana R. B., Fuller J. K., Campbell D. W., McAleer M. J., Sailer J. A. Heart transplantation. Four years' experience with conventional immunosuppression. JAMA. 1984 Mar 23;251(12):1563–1566. doi: 10.1001/jama.251.12.1563. [DOI] [PubMed] [Google Scholar]
  7. Griffith B. P., Hardesty R. L., Bahnson H. T. Powerful but limited immunosuppression for cardiac transplantation with cyclosporins and low-dose steroid. J Thorac Cardiovasc Surg. 1984 Jan;87(1):35–42. [PubMed] [Google Scholar]
  8. Kaye M. P., Elcombe S. A., O'Fallon W. M. The International Heart Transplantation Registry. The 1984 report. J Heart Transplant. 1985 May;4(3):290–292. [PubMed] [Google Scholar]
  9. LOWER R. R., SHUMWAY N. E. Studies on orthotopic homotransplantation of the canine heart. Surg Forum. 1960;11:18–19. [PubMed] [Google Scholar]
  10. Lanza R. P., Cooper D. K., Cassidy M. J., Barnard C. N. Malignant neoplasms occurring after cardiac transplantation. JAMA. 1983 Apr 1;249(13):1746–1748. [PubMed] [Google Scholar]
  11. Lower R. R., Szentpetery S., Quinn J., Thomas F. T. Selection of patients for cardiac transplantation. Transplant Proc. 1979 Mar;11(1):293–295. [PubMed] [Google Scholar]
  12. Pennock J. L., Oyer P. E., Reitz B. A., Jamieson S. W., Bieber C. P., Wallwork J., Stinson E. B., Shumway N. E. Cardiac transplantation in perspective for the future. Survival, complications, rehabilitation, and cost. J Thorac Cardiovasc Surg. 1982 Feb;83(2):168–177. [PubMed] [Google Scholar]
  13. Pennock J. L., Oyer P. E., Reitz B. A., Jamieson S. W., Bieber C. P., Wallwork J., Stinson E. B., Shumway N. E. Cardiac transplantation in perspective for the future. Survival, complications, rehabilitation, and cost. J Thorac Cardiovasc Surg. 1982 Feb;83(2):168–177. [PubMed] [Google Scholar]
  14. Rosenthal J. T., Shaw B. W., Jr, Hardesty R. L., Griffith B. P., Starzl T. E., Hakala T. R. Principles of multiple organ procurement from cadaver donors. Ann Surg. 1983 Nov;198(5):617–621. doi: 10.1097/00000658-198311000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rubin R. H., Russell P. S., Levin M., Cohen C. From the National Institutes of Health. Summary of a workshop on cytomegalovirus infections during organ transplantation. J Infect Dis. 1979 Jun;139(6):728–734. doi: 10.1093/infdis/139.6.728. [DOI] [PubMed] [Google Scholar]
  16. Stehle R. L. Local Anaesthetics-A Step Forward. Can Med Assoc J. 1925 Dec;15(12):1253–1254. [PMC free article] [PubMed] [Google Scholar]
  17. Szentpetery S., Goldman M. H., Woody D., Salim J., Mohanakumar T., Lower R. Orthotopic cardiac transplantation in a Veterans Administration hospital. Arch Surg. 1984 Apr;119(4):390–393. doi: 10.1001/archsurg.1984.01390160026006. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES