Initial clinical experience with heart transplantation

Clinical experience with cardiac transplantation in 2 patients with terminal heart disease is described. The first patient suffered chronic and progressive heart failure due to postviral myocardial fibrosis and coronary artery disease. Following successful operation multiple complications occurred, and the patient died on the fifteenth postoperative day of gastrointestinal bleeding and gram negative sepsis. Histologic evidence of mild rejection was present at postmortem examination. The second patient presented with terminal ischemic heart disease complicated by severe pulmonary hypertension. Postoperatively severe and unremitting arterial hypoxemia caused death on the third postoperative day. Postmortem examination failed to show evidence of rejection but revealed advanced obliterative changes in the pulmonary vasculature.

Despite the disappointing outcome of these 2 cases, cardiac transplantation in man deserves extensive clinical trial. The methods of clinical study and eventual objectives are outlined.