Human Cardiac Transplantation

Transplantation of the human heart may provide palliation for patients with end-stage cardiac disease for whom no other treatment is available. Cardiac transplantation was performed in 17 patients undergoing 18 heart transplants. Five early deaths occurred: three from acute cardiac rejection after one week and one each from pre-existing diseases and complications of immunosuppressive therapy. The transplanted heart provided effective cardiac function for each surviving patient. Two late deaths occurred from sepsis. Three patients died between five and nearly seven months after operation from chronic cardiac rejection. Clinical investigations of the role of histocompatibility testing, methods of immunosuppressive therapy, recognition and management of rejection, search for preformed anti-heart antibodies, physiological evaluation of the denervated transplanted heart, and causes of histological changes in the transplanted hearts are continuing. Further clinical trial is needed to determine the role of cardiac transplantation in palliating advanced myocardial insufficiency.