The Annals of Thoracic Surgery, Vol 44, 186-188, Copyright © 1987 by The Society of Thoracic Surgeons
Cardiac transplantation: first-year experience in a community hospital
MH Schatzlein, AC Peterson, RH Scheeringa, WR Clark Jr, JT Lucas, WW Pond, SH Thong, RL Lindsey, RM Johnston 2d and SM Jones
The issue of decentralizing heart transplant services, formerly restricted
to a few large medical centers, is currently under review by federal and
state governments. We present the results of the first year of cardiac
transplantation at a 385-bed community hospital. Twelve patients were
selected according to generally accepted criteria from a pool of 24
referrals, all from within 75 miles of our institution. All patients were
in New York Heart Association Class IV preoperatively. The one-year
survival rate was found to be 82%, which is equivalent to that reported by
established centers. All surviving patients were fully rehabilitated. Rates
of infection and rejection were lower than expected, and costs were about
half the national average. This series, in all likelihood, tests the limits
to which the decentralization of cardiac transplant services can be taken.
We conclude that cardiac transplantation can be accomplished at a community
hospital with results, even for the first patients undergoing
transplantation, comparable to those obtained by established programs at
major medical centers.
