[Orthotopic heart transplantation: clinical experience on 56 patients].
OBJECTIVE
To summarize the clinical experience on 56 patients undergoing orthotopic heart transplantation.


METHODS
Between May 2000 and December 2003 56 patients, 47 with cardiomyopathy, 2 with end-stage valvular heart disease, 2 with end-stage ischemic heart disease, 2 with primary malignant cardiac tumor, 1 with complicated congenital heart disease, 1 with muscular dystrophy cardiomyopathy, and 1 with refractory malignant ventricular arrhythmias, underwent orthotopic heart transplantation in the Transplantation Center of Fudan University. The operative procedures included 19 conventional Stanford orthotopic cardiac transplantation in 19 cases and bicaval anastomotic cardiac transplantation in 37 cases. Postoperatively, the patients were prescribed with cyclosporine A + corticosteroids + MMF or FK506 + corticosteroids + MMF as anti-rejection therapy.


RESULTS
One patient undergoing his fifth operation died of bleeding 3 days after operation. All survivors were followed-up for 12.4 months on average. Five patients died within 1 year postoperatively with a one-year survival rate of 91%. One patient died of allograft vasculopathy 38 months after operation. Other patients enjoyed heart function recovering to class I-II (NYHA).


CONCLUSIONS
With proper recipient selection, excellent donor heart conservation, bicaval anastomotic technique, and efficient postoperative surveillance and treatment, heart transplantion may produce satisfying mid-term results.
Wang
Chun-sheng
CS
Department of Cardiothoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai Institute of Cardiovascular Diseases, Transplantation Center of Fudan University, Shanghai 200032, China.
Chen
Hao
H
Hong
Tao
T
Zhao
Qiang
Q
Ding
Wen-jun
WJ
Wang
Yi-qing
YQ
Song
Kai
K
Lai
Hao
H
Zhao
Dong
D
Yang
Shou-guo
SG
D000293:Adolescent; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
D007166:Immunosuppressive Agents