DENTON A. COOLEY, M.D.; GRADY L. HALLMAN, M.D.; DOMINGO LIOTTA, M.D.; ROBERT D. LEACHMAN, M.D.; BRUNO J. MESSMER, M.D.
Twenty-one cardiac transplants were performed in 20 patients, including a second allografting in one case and a combined cardiopulmonary transplant in another. A two-stage approach to cardiac replacement was implemented, using an orthotopic total cardiac prosthesis in a patient whose heart failed after cardiopulmonary bypass. For 64 hr the pump supported circulation until a donor heart was secured for transplantation. Function of all allografts was satisfactory and permitted several patients to resume normal activity, but long-term survival was usually prevented by rejection, or infection, or both. Histocompatibility apparently influenced results. Six recipients lived 5 months or more, and one lived more than 16 months. None are alive today. Our experience suggests that successful application of cardiac transplantation is hindered by immunologic problems and the inadequate supply of donors. In cases where a patient's heart fails during open heart surgery and no donor heart is immediately available, a two-stage approach to cardiac replacement may be appropriate, using a mechanical device for temporary cardiac substitution.
COOLEY DA, HALLMAN GL, LIOTTA D, et al. Cardiac Replacement: Current Status of Cardiac Transplants and Prostheses. Ann Intern Med. 1970;73:677–681. doi: 10.7326/0003-4819-73-5-677
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Published: Ann Intern Med. 1970;73(5):677-681.
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