title: Cardiac transplantation: first-year experience in a community hospital.
abstract: 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.
authors.forename: M H
authors.initials: MH
authors.lastname: Schatzlein
authors.forename: A C
authors.initials: AC
authors.lastname: Peterson
authors.forename: R H
authors.initials: RH
authors.lastname: Scheeringa
authors.forename: W R
authors.initials: WR
authors.lastname: Clark
authors.forename: J T
authors.initials: JT
authors.lastname: Lucas
authors.forename: W W
authors.initials: WW
authors.lastname: Pond
authors.forename: S H
authors.initials: SH
authors.lastname: Thong
authors.forename: R L
authors.initials: RL
authors.lastname: Lindsey
authors.forename: R M
authors.initials: RM
authors.lastname: Johnston
authors.forename: S M
authors.initials: SM
authors.lastname: Jones
mesh_terms: D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D016027:Heart Transplantation; D006745:Hospital Bed Capacity, 300 to 499; D006752:Hospital Planning; D006764:Hospitals, Community / Q000592:standards*; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012017:Referral and Consultation; D012959:Socioeconomic Factors