Summary
As of June 30, 1969, 21 heart transplantations have been performed in 20 patients having end-stage heart disease. The surgical technique for cardiac and cardiopulmonary allotransplantation is standardized and no patient in the present series died for technical reasons. Postoperative catheterization studies showed adequate performance of the allografts with slower but satisfactory adaptation to exercise.
Survival after cardiac allotransplantation ranged from 14 h to nearly 9 months. At the present time two patients are still alive, 27 and 226 days after transplantation. Rejection, either acute or chronic, was the primary cause of death in 10 patients: infection stimulated by the immunosuppression, in five.
Lack of donors represents another serious problem. An attempt to save a patient with a cardiac xenograft failed. New hope is offered by the first clinical use of an orthotopic cardiac prosthesis to bridge the period between complete failure of a patient's heart and the availability of an allograft.
The results demonstrate that cardiac allotransplantation can be an effective palliation for patients with end-stage heart disease, but many immunological problems must be solved before wide clinical application can be approved.
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Cooley, D.A., Messmer, B.J., Hallman, G.L. et al. Technique and results of human heart transplantation. Langenbecks Arch Chiv 326, 5–24 (1969). https://doi.org/10.1007/BF01238410
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DOI: https://doi.org/10.1007/BF01238410