title: Steroid pulse therapy combined with plasmapheresis for clinically compromised patients after heart transplantation.
abstract: BACKGROUND
  The most serious complication after heart transplantation is allograft dysfunction. Patients presenting with compromised hemodynamics show a high incidence of mortality. The most common reason for allograft dysfunction is rejection. We have employed steroid pulse therapy combined with plasmapheresis for hemodynamically compromised patients after heart transplantation.
  
  
  RESULTS
  Steroid pulse therapy and plasmapheresis were performed on 35 patients who underwent orthotopic heart transplantation for graft dysfunction. Thus treatment rescued ventricular function and improved the ejection fraction in 77% of patients, among who ever 71.4% showed improved New York Heart Association (NYHA) functional class.
  
  
  CONCLUSIONS
  Steroid pulse therapy combined with plasmapheresis improved the cardiac contractility and NYHA functional class of most heart transplant recipients with graft dysfunction.
authors.affiliation: Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: H-W
authors.initials: HW
authors.lastname: Chou
authors.forename: N-H
authors.initials: NH
authors.lastname: Chi
authors.forename: M-H
authors.initials: MH
authors.lastname: Lin
authors.forename: N-K
authors.initials: NK
authors.lastname: Chou
authors.forename: C-I
authors.initials: CI
authors.lastname: Tsao
authors.forename: H-Y
authors.initials: HY
authors.lastname: Yu
authors.forename: Y-S
authors.initials: YS
authors.lastname: Chen
authors.forename: S-S
authors.initials: SS
authors.lastname: Wang
mesh_terms: D003131:Combined Modality Therapy; D006084:Graft Rejection / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006331:Heart Diseases / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D009200:Myocardial Contraction; D010956:Plasmapheresis; D020551:Pulse Therapy, Drug; D013256:Steroids / Q000008:administration & dosage*; D013318:Stroke Volume; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids