HEART-TRANSPLANTATION - CLINICAL-STUDY AN D RESULTS OF THE FIRST 100 GRAFTS

Objectives: Global results of entire series of heart transplantations are essential to better evaluate survival rates. We therefore report t he results of our first 100 transplantations. Methods: Orthotopic hear t transplantation was performed in 82 men and 18 women (age 50.5 +/- 1 1.4; range 9-65). Sixteen were over 60. Primitive cardiomyopathies (n= 51) and coronary artery disease (n=44) were the most frequent underlyi ng diseases. Secondary morbidity was evaluated according to the intern ational classification on the basis of pathological examination of end o-myocardial biopsies. Results: Immediate post-operative survival rate was 89 percent : there was 1 peroperative death, 7 deaths due to pers istent pulmonary hypertension and 4 due to irreversible left ventricul ar failure. Eight deaths occurred during the 2nd and 3rd postoperative months for an overall early survival rate of 81 percent, After a mean follow-up of 2.4 years (maximum 6.16 yr), the actuarial survival rate at 5 years was 58 percent. Among the 470 biopsies performed, rejectio n was classified weak or null in 326, moderate in 125 and severe in 19 . Pulmonary artery resistance, immunosuppression and, later, the risk of coronary artery disease and intrinsic graft changes were the three major problems encountered in this series. Conclusions: Despite its li mits, heart transplantation remains an effective therapeutic option, p articularly for young patients in good general health.