HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): John R. Dein Edward B. Stinson Vaughn A. Starnes Norman E. Shumway Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dein, J. R. Articles by Shumway, N. E. Search for Related Content PubMed PubMed Citation Articles by Dein, J. R. Articles by Shumway, N. E.

Ann Thorac Surg 1989;48:350-355
© 1989 The Society of Thoracic Surgeons

---

Articles

Cardiac Retransplantation in the Cyclosporine Era

Department of Cardiovascular Surgery, Stanford University Medical Center, Stanford, California

^* Address reprint requests to Dr Dein, Department of Surgery, Ochsner Clinic, 1514 Jefferson Highway, New Orleans, LA 70121

Between December 1980, when immunosuppression with cyclosporine was introduced, and May 1988, 288 patients underwent primary transplantation for end-stage cardiac disease (group TX). Fourteen patients underwent retransplantation for accelerated graft atherosclerosis (group RTXAGA), and 9 underwent retransplantation for intractable acute allograft rejection (group RTXREJ). Cumulative patient follow-up was 724 patient-years (range, 1 month to 7.5 years; mean, 2.3 years). Within the first 3 postoperative months, no differences were noted between groups for linearized rates of infection or rejection except between the rate of rejection for group TX (1.69 ± 0.09 events/100 patient-days) and group RTXAGA (0.94 ± 0.3 events/100 patient-days) (p < 0.02). No significant differences existed between groups for actuarial rates of remaining rejection-free or infection-free for more than 7.5 years. No significant differences in actuarial survival existed except between group TX (81% ± 2% at 1 year and 58% ± 4% at 5 years) and group RTXREJ (44% ± 17% at 1 year and 44% ± 0% at 5 years) (p < 0.05). We conclude that patients who undergo retransplantation for accelerated graft atherosclerosis experience a lower rate of early rejection and similar rates of infection and survival compared with patients who receive primary transplants. Cardiac retransplantation for rejection incurs rejection and infection at rates similar to those of primary procedures. However, patients who undergo retransplantation for rejection survive these complications significantly less often than do patients who receive primary transplants. This information should be considered when scarce donor hearts become available and retransplantation is contemplated.

This article has been cited by other articles:

				Y. S. Tjang, G. Tenderich, L. Hornik, S. Wlost, A. Bairaktaris, and R. Korfer Long-term experiences on cardiac retransplantation in adults Eur J Cardiothorac Surg, December 1, 2007; 32(6): 923 - 925. [Abstract] [Full Text] [PDF]

				K. R. Kanter, R. N. Vincent, A. M. Berg, W. T. Mahle, J. M. Forbess, and P. M. Kirshbom Cardiac retransplantation in children Ann. Thorac. Surg., August 1, 2004; 78(2): 644 - 649. [Abstract] [Full Text] [PDF]

				B. T. Bethea, D. D. Yuh, J. V. Conte, and W. A. Baumgartner Heart Transplantation Card. Surg. Adult, January 1, 2003; 2(2003): 1427 - 1460. [Full Text]

				R. John, J. M. Chen, A. Weinberg, M. C. Oz, D. Mancini, S. Itescu, M. E. Galantowicz, C. R. Smith, E. A. Rose, and N. M. Edwards Long-Term Survival After Cardiac Retransplantation: A Twenty-Year Single-Center Experience J. Thorac. Cardiovasc. Surg., March 1, 1999; 117(3): 543 - 555. [Abstract] [Full Text] [PDF]

				B. Schnetzler, A. Pavie, R. Dorent, A.-C. Camproux, P. Leger, A. Delcourt, and I. Gandjbakhch Heart Retransplantation: A 23-Year Single-Center Clinical Experience Ann. Thorac. Surg., April 1, 1998; 65(4): 978 - 983. [Abstract] [Full Text] [PDF]

				G. E. Sarris, K. A. Moore, J. S. Schroeder, S. A. Hunt, M. B. Fowler, H. B. Valantine, R. H. Vagelos, M. E. Billingham, P. E. Oyer, E. B. Stinson, et al. Cardiac transplantation: The Stanford experience in the cyclosporine era J. Thorac. Cardiovasc. Surg., August 1, 1994; 108(2): 240 - 252. [Abstract] [Full Text]

				G. Y. Ott, D. J. Norman, J. D. Hosenpud, R. E. Hershberger, R. M. Ratkovec, and A. Cobanoglu Heart transplantation in patients with previous cardiac operations:Excellent clinical results J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 203 - 209. [Abstract] [Full Text]

				P. A. Ubel, R. M. Arnold, and A. L. Caplan Rationing Failure: The Ethical Lessons of the Retransplantation of Scarce Vital Organs JAMA, November 24, 1993; 270(20): 2469 - 2474. [Abstract] [PDF]

				S. V. Karwande, R. D. Ensley, D. G. Renlund, W. A. Gay Jr, W. E. Richenbacher, D. B. Doty, M. E. Hammond, J. D. Marks, and The Registry of the International Society Cardiac retransplantation: A viable option? Ann. Thorac. Surg., November 1, 1992; 54(5): 840 - 845. [Abstract] [PDF]