Abstract
From July 1982 to November 1983 18 patients (one female) underwent orthotopic cardiac transplantation at the Texas Heart Institute. Prednisone and cyclosporin were used for maintenance immunosuppression in all patients. Cumulative follow up has now been for 90 patient months (0.75-20 months). Rejection occurred in 10 recipients (56%) and was fatal in three, giving an incidence of rejection of 0.6 episodes per recipient and a mortality rate of 30% per episode. At one year 39% of recipients were free of infection and 73% free of fatal rejection. Infection episodes occurred on 32 occasions in 14 patients and 24 episodes required treatment. There were no infection related deaths, although the first year actuarial freedom from infection rate was only 24%. With 14 of the 18 patients surviving (78%), an actuarial one year survival of 74%, and freedom from major complications in the short term, the efficacy of cyclosporin immunosuppression for cardiac transplantation is confirmed.
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Selected References
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- 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]
- Borel J. F. Immunosuppressive properties of cyclosporin A (CY-A). Transplant Proc. 1980 Jun;12(2):233–233. [PubMed] [Google Scholar]
- Calne R. Y., Rolles K., White D. J., Thiru S., Evans D. B., Henderson R., Hamilton D. L., Boone N., McMaster P., Gibby O. Cyclosporin-A in clinical organ grafting. Transplant Proc. 1981 Mar;13(1 Pt 1):349–358. [PubMed] [Google Scholar]
- Calne R. Y., Rolles K., White D. J., Thiru S., Evans D. B., McMaster P., Dunn D. C., Craddock G. N., Henderson R. G., Aziz S. Cyclosporin A initially as the only immunosuppressant in 34 recipients of cadaveric organs: 32 kidneys, 2 pancreases, and 2 livers. Lancet. 1979 Nov 17;2(8151):1033–1036. doi: 10.1016/s0140-6736(79)92440-1. [DOI] [PubMed] [Google Scholar]
- Cooley D. A., Bloodwell R. D., Hallman G. L. Cardiac transplantation for advanced acquired heart disease. J Cardiovasc Surg (Torino) 1968 Sep-Oct;9(5):403–413. [PubMed] [Google Scholar]
- Cooley D. A., Frazier O. H., Kahan B. D. Cardiac transplantation with the use of cyclosporin a for immunologic suppression. Tex Heart Inst J. 1982 Sep;9(3):247–251. [PMC free article] [PubMed] [Google Scholar]
- Copeland J. G., Salomon N. W. Recipient selection for cardiac transplantation. Ariz Med. 1980 Nov;37(11):758–760. [PubMed] [Google Scholar]
- Gaudiani V. A., Stinson E. B., Alderman E., Hunt S. A., Schroeder J. S., Perlroth M. G., Bieber C. P., Oyer P. E., Reitz B. A., Jamieson S. W. Long-term survival and function after cardiac transplantation. Ann Surg. 1981 Oct;194(4):381–385. doi: 10.1097/00000658-198110000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gurwith M. J., Stinson E. B., Remington J. S. Aspergillus infection complicating cardiac transplantation. Report of five cases. Arch Intern Med. 1971 Oct;128(4):541–545. [PubMed] [Google Scholar]
- Hallman G. L., Cooley D. A. Operative technique for cardiac transplantation. Laval Med. 1970 Feb;41(2):191–194. [PubMed] [Google Scholar]
- Mason J. W., Stinson E. B., Hunt S. A., Schroeder J. S., Rider A. K. Infections after cardiac transplantation: relation to rejection therapy. Ann Intern Med. 1976 Jul;85(1):69–72. doi: 10.7326/0003-4819-85-1-69. [DOI] [PubMed] [Google Scholar]
- Oyer P. E., Stinson E. B., Bieber C. P., Reitz B. A., Raney A. A., Baumgartner W. A., Shumway N. E. Diagnosis and treatment of acute cardiac allograft rejection. Transplant Proc. 1979 Mar;11(1):296–303. [PubMed] [Google Scholar]
- 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]
- Remington J. S., Gaines J. D., Griepp R. B., Shumway N. E. Further experience with infection after cardiac transplantation. Transplant Proc. 1972 Dec;4(4):699–705. [PubMed] [Google Scholar]
- Sibley R. K., Rynasiewicz J., Ferguson R. M., Fryd D., Sutherland D. E., Simmons R. L., Najarian J. S. Morphology of cyclosporine nephrotoxicity and acute rejection in patients immunosuppressed with cyclosporine and prednisone. Surgery. 1983 Aug;94(2):225–234. [PubMed] [Google Scholar]
- Starzl T. E., Klintmalm G. B., Porter K. A., Iwatsuki S., Schröter G. P. Liver transplantation with use of cyclosporin a and prednisone. N Engl J Med. 1981 Jul 30;305(5):266–269. doi: 10.1056/NEJM198107303050507. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stehle R. L. Local Anaesthetics-A Step Forward. Can Med Assoc J. 1925 Dec;15(12):1253–1254. [PMC free article] [PubMed] [Google Scholar]
- Stinson E. B., Bieber C. P., Griepp R. B., Clark D. A., Shumway N. E., Remington J. S. Infectious complications after cardiac transplantation in man. Ann Intern Med. 1971 Jan;74(1):22–36. doi: 10.7326/0003-4819-74-1-22. [DOI] [PubMed] [Google Scholar]
- Williams T. W., Jr Prevention of infections in transplantation patients. Transplant Proc. 1972 Dec;4(4):707–710. [PubMed] [Google Scholar]
