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Recent experience with heart transplantation.
Abstract: The major factors contributing to the recommencement of clinical heart transplantation in the United Kingdom last year were the steadily improving results from Stanford University, the clarification of the diagnosis of brain death, and advances in preserving donor hearts. Twelve men aged 16 to 52 years received heart transplants at Papworth Hospital from January 1979 to July 1980. Six had cardiomyopathies and six ischaemic heart disease. The donors were aged 16 to 35 (mean 21) years. A combination of road and air transport was used to transport the heart to Papworth in seven cases. The total donor heart ischaemic time ranged from 108 to 171 minutes (mean 151), and early graft function was satisfactory in all cases. Postoperative management was directed towards preventing rejection and infection. Equine antihuman thymocyte globulin, prednisolone, and azathioprine were used for immunosuppression. Endomyocardial biopsy was performed every 10 to 14 days during the early postoperative period. There were three deaths: one at 17 days from brain damage and two at 59 and 76 days from rejection. Of the remaining nine patients six left hospital and three returned to work. The number of patients who might benefit from heart transplantation is large, but the cost is high. The cost would fall if an effective non-toxic immunosuppressive agent were developed. Meanwhile, a careful evaluation of the benefits of heart transplantation should continue.
Publication Date: 1980-09-13 PubMed ID: 7000272PubMed Central: PMC1713995DOI: 10.1136/bmj.281.6242.699Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research conducted from January 1979 to July 1980 at Papworth Hospital describes their experience with heart transplantations, which resumed in the United Kingdom after improvements in Stanford University’s transplant results, clearer definition of brain death, and greater advancements in preserving donor hearts. The study reports on the experiences of twelve male recipients, aged 16 to 52 years, covering factors such as donor age, transportation method, postoperative management, and outcomes.
Study Participants
In the study, twelve male patients aged between 16 and 52 years underwent heart transplant procedures. The reasons for the transplant were various:
- Six patients suffered from cardiomyopathies, a disease of the heart muscle that can make it harder for the heart to pump blood to the rest of your body.
- Six patients had ischaemic heart disease, a condition that affects the supply of blood to the heart.
Donor Information and Transportation
The age of the heart donors in this study ranged between 16 to 35 years. In most cases, the hearts were transported to the hospital by a mixture of road and air transportation. The approximate time the donor heart was without blood supply, known as the ischemic time, ranged from 108 to 171 minutes, with satisfactory early graft function recorded in all cases.
Postoperative Management
After the heart transplantation, patients were managed with a focus on preventing rejection of the transplanted heart and managing potential infections:
- Immunosuppression was facilitated through the use of equine antihuman thymocyte globulin, prednisolone, and azathioprine.
- Endomyocardial biopsies were also performed on a regular basis – every 10 to 14 days – following the procedure to monitor for signs of rejection.
Outcome and Recommendations
The report notes that three of the twelve patients died after the surgery:
- One death occurred after 17 days from brain damage.
- Two deaths were reported after 59 and 76 days from rejection of the heart transplant.
The nine remaining patients had reasonably successful outcomes, with six patients discharged from the hospital and three returning to their workplaces.
The researchers conclude that while heart transplantation can benefit a significant population of patients, the associated costs are currently high. They suggest that the development of effective, non-toxic immunosuppressive treatments could help in reducing these costs. In the meantime, the benefits of heart transplantation need to be continuously and carefully evaluated.
Cite This Article
APA
English TA, Cooper DK, Cory-Pearce R.
(1980).
Recent experience with heart transplantation.
Br Med J, 281(6242), 699-702.
https://doi.org/10.1136/bmj.281.6242.699 Publication
Researcher Affiliations
MeSH Terms
- Adolescent
- Adult
- Brain Death
- Graft Rejection
- Heart Transplantation
- Humans
- Immunosuppression Therapy
- Male
- Middle Aged
- Organ Preservation
- Postoperative Care
- Tissue Donors
- Transplantation, Homologous
References
This article includes 12 references
- LOWER RR, SHUMWAY NE. Studies on orthotopic homotransplantation of the canine heart.. Surg Forum 1960;11:18-9.
- Lower RR, Dong E Jr, Glazener FS. Electrocardiograms of dogs with heart homografts.. Circulation 1966 Mar;33(3):455-60.
- Griepp RB, Stinson EB, Bieber CP, Reitz BA, Copeland JG, Oyer PE, Shumway NE. Control of graft arteriosclerosis in human heart transplant recipients.. Surgery 1977 Mar;81(3):262-9.
- Krikorian JG, Anderson JL, Bieber CP, Penn I, Stinson EB. Malignant neoplasms following cardiac transplantation.. JAMA 1978 Aug 18;240(7):639-43.
- Griepp RB, Stinson EB, Clark DA, Dong E Jr, Shumway NE. The cardiac donor.. Surg Gynecol Obstet 1971 Nov;133(5):792-8.
- Jamieson SW, Reitz BA, Oyer PE, Bieber CP, Stinson EB, Shumway NE. Current management of cardiac transplant recipients.. Br Heart J 1979 Dec;42(6):703-8.
- Barnard CN. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town.. S Afr Med J 1967 Dec 30;41(48):1271-4.
- Baumgartner WA, Reitz BA, Bieber CP, Oyer PE, Shumway NE, Stinson EB. Current expectations in cardiac transplantation.. J Thorac Cardiovasc Surg 1978 Apr;75(4):525-30.
- Remington JS, Gaines JD, Griepp RB, Shumway NE. Further experience with infection after cardiac transplantation.. Transplant Proc 1972 Dec;4(4):699-705.
- LOWER RR, STOFER RC, HURLEY EJ, DONG E Jr, COHN RB, SHUMWAY NE. Successful homotransplantation of the canine heart after anoxic preservation for seven hours.. Am J Surg 1962 Aug;104:302-6.
- Griepp RB, Stinson EB, Bieber CP, Oyer PE, Reitz BA, Copeland JG, Shumway NE. Heart and other organs. Increasing patient survival following heart transplantation.. Transplant Proc 1977 Mar;9(1):197-201.
- LOWER RR, STOFER RC, SHUMWAY NE. Homovital transplantation of the heart.. J Thorac Cardiovasc Surg 1961 Feb;41:196-204.
Citations
This article has been cited 3 times.- Mackintosh AF, Carmichael DJ, Wren C, Cory-Pearce R, English TA. Sinus node function in first three weeks after cardiac transplantation. Br Heart J 1982 Dec;48(6):584-8.
- Harkiss GD, Brown DL, Cory-Pearce R, English TA. Serial analysis of circulating immune complexes, complement, and antithymocyte globulin antibodies in heart transplant recipients. J Clin Immunol 1983 Apr;3(2):117-26.
- Harkiss GD, Brown DL, Smith DJ, Nagington J. Antibody moieties within circulating immune complexes in heart transplant recipients. Clin Exp Immunol 1983 Jan;51(1):21-8.
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