The Annals of Thoracic Surgery, Vol 39, 303-307, Copyright © 1985 by The Society of Thoracic Surgeons
Cardiac transplantation at the Texas Heart Institute: comparative analysis of two groups of patients (1968-1969 and 1982-1983)
OH Frazier, DA Cooley, GA Painvin, LB Chandler and OU Okereke
Two groups of heart transplant recipients were studied. Patients in Group 1
underwent heart transplantation from May, 1968, to November, 1969. They
were compared with Group 2, a series begun in July, 1982, when the current
cardiac transplantation program was renewed at the Texas Heart Institute,
and terminated in December, 1983. Patient selection, management, and
results were compared. With a cumulative follow-up of 64 patient-months
(Group 1) versus 93 patient-months (Group 2), the actuarial 18-month
survival was 0 in Group 1 versus 70% in Group 2. Nine of the 18 patients in
Group 1 died of rejection versus 4 of the 18 patients in Group 2. There
were 6 infection-related deaths in Group 1 and none in Group 2. Using
linearized rates based on 100 patient-months, the incidences of rejection
and infection were, respectively, 23 versus 10.7 (p less than 0.05) and 64
versus 34 (p less than 0.05) between Groups 1 and 2. Incidence, pattern,
and severity of these major complications have been reduced significantly.
Over the last decade, there have been improvements in the selection of
potential candidates, better management of donors, improved graft
preservation, and the introduction of more selective immunosuppression.
