Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart transplantation so far. The purpose of
this
article is to report short-term result of cardiac transplantation at our center.
Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mean recipient age was 34 years(range 11 to 54 years) and mean doner age was 28.4 years(16 to 50 years).
Mean
graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was ll months(3 to 17 months).
Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient.
The preoperative status of the recipients were state I(50%)and II(50%)by UNOS classification and class III(5 patients) and class IV(9)by NYHA functional class.
All patients were treated with triple-drug immunosuppression(cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up.
Causes of infection were aspergillosis(2), and hepes zoster(1), CMV pneumonitis(1). Permanent pacemaker was inserted in 1 patient. Currently 9 patients are alive with seven patients in NYHA functional class I and two in class II.
The ejection fraction mcreased from preoperative vaiue of 19.9±3.4% to postoperative value of 69.0±5.6%.
The causes of death were cellular rejection(1), chronic graft failure due to size-mismatching(1), respiratory insufficiency due to asthma attack(1), subarachnoid hemorrhage(1), and R/O humoral rejection(1).
These data demonstrate that short-term outcome of cardiac transplantation in our hospital is promising. However, further progress is necessary is necessary in donor & recipient selection, postoperative infection surveillance and care of humoral
rejection.
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