title: Heart transplantation at Groote Schuur Hospital, Cape Town. Twenty years' experience.
abstract: Human allogeneic heart transplantation was started at Groote Schuur Hospital in Cape Town in 1967. Since then 110 hearts (61 heterotopic and 49 orthotopic) and 12 heart-lung transplantations have been performed in the unit. Ten procedures were retransplantations including 2 third interventions. The patients fall into three groups according to their immunosuppressive therapy: group A (N = 55) from 1967 to 1982 received the so-called 'conventional treatment' (azathioprine, methylprednisolone and antithymocyte globulin (ATG)); group B (N = 15) from 1983 to 1984 received cyclosporin A in high dosage, together with methylprednisolone; and group C (N = 30) received quadruple drug therapy of low-dose cyclosporin A, together with azathioprine, methylprednisolone in lower dosages and antithymocyte globulin (for the first 4-6 days and rescue-ATG for severe rejection). The results have improved significantly over the years. The actuarial survival rate after heart transplantation within the last 12 months is 94%. Several important steps have been inaugurated: in 1973 heterotopic heart transplantation was initiated and in 1984 hormonal therapy of brain-dead organ donors was started. Radionuclide scanning, in combination with endomyocardial biopsies, has proved to be a very sensitive means of monitoring rejection.
authors.affiliation: Department of Cardiothoracic Surgery, University of Cape Town.
authors.forename: B A
authors.initials: BA
authors.lastname: Reichart
authors.forename: H C
authors.initials: HC
authors.lastname: Reichenspurner
authors.forename: J A
authors.initials: JA
authors.lastname: Odell
authors.forename: D K
authors.initials: DK
authors.lastname: Cooper
authors.forename: D
authors.initials: D
authors.lastname: Novitzky
authors.forename: P A
authors.initials: PA
authors.lastname: Human
authors.forename: U O
authors.initials: UO
authors.lastname: Von Oppell
authors.forename: E A
authors.initials: EA
authors.lastname: Becerra
authors.forename: D H
authors.initials: DH
authors.lastname: Boehm
authors.forename: A G
authors.initials: AG
authors.lastname: Rose
mesh_terms: D003524:Cyclosporins / Q000627:therapeutic use; D016027:Heart Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D013019:South Africa; D014184:Transplantation, Homologous / Q000401:mortality
chemical_list: D003524:Cyclosporins