title: Orthotopic cardiac transplantation in a Veterans Administration hospital.
abstract: Of 57 patients referred to the McGuire Veterans Administration Medical Center, Richmond, Va, for evaluation for cardiac transplantation, 18 received allografts. The overall graft survival rate was 67% from two to 24 months after transplantation. In 15 recipients receiving immunosuppression with rabbit anti-human thymocyte globulin, prednisone, and azathioprine, previous transfusion and HLA-DR matching resulted in improved graft survival. In three patients receiving cyclosporin and prednisone, hypertension, nephrotoxicity, and hepatotoxicity were seen. All surviving recipients were in functional New York Heart Association class 1 or 2. The cost to the Medical Center was $23,275 per transplant. The results achieved at the center suggested that a regionalized cardiac transplant program can be established within the VA health care system with acceptable clinical results and significant financial savings.
mesh_terms: D000328:Adult; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D006084:Graft Rejection; D006085:Graft Survival / Q000187:drug effects; D016027:Heart Transplantation; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011241:Prednisone / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000276:immunology; D014768:Virginia
chemical_list: D000961:Antilymphocyte Serum; D001379:Azathioprine; D011241:Prednisone