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History of Heart Transplant

  • Nina Badoe
  • Palak Shah
Living reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

Cardiac transplantation represents the gold standard therapy for patients with advanced heart failure refractory to medical and device therapy. Decades of clinical and animal-based research laid the foundation for the first heart transplant performed on December 3, 1967 by Christiaan Barnard in Cape Town, South Africa. The initial enthusiasm for transplantation spread quickly and about 100 transplants were performed in the year that followed 1967. Early immunosuppressive regimens consisted of steroids and azathioprine. Early on, due to unthwarted and often undiagnosed rejection, 1-month mortality after cardiac transplant exceeded 50% and most centers abandoned the procedure by 1970. In 1972, Phillips Caves developed the technique for an endomyocardial biopsy and together with Margaret Billingham developed objective criteria for the histopathologic assessment of allograft rejection. Norman Shumway pioneered the use of a calcineurin inhibitor, cyclosporine as a more potent immunosuppressive agent to mitigate rejection after cardiac transplantation. With the successful incorporation of cyclosporine, short and intermediate-term survival improved dramatically and between 1980 and 1990, the number of heart transplants performed across the globe grew exponentially from 100 to 4,000 transplants annually.

Keywords

Heart failure Cardiac transplantation Cardiopulmonary bypass Rejection Immunosuppression 

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of MedicineInova Fairfax Medical CampusFalls ChurchUSA
  2. 2.Department of Heart Failure and TransplantInova Heart and Vascular InstituteFalls ChurchUSA

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