PMID- 9476540
OWN - NLM
STAT- MEDLINE
DCOM- 19980407
LR  - 20041117
IS  - 0910-8327 (Print)
IS  - 0910-8327 (Linking)
VI  - Suppl 12
DP  - 1997
TI  - Points to note from indications for heart transplantation to post-heart 
      transplant care: from the care of patients with refractory heart failure and 
      overseas heart transplantation.
PG  - 37-40
AB  - To examine important points surrounding the indications for heart transplantation 
      (HTX) to care after HTX, we reviewed 22 patients with refractory heart failure 
      aged less than 60 years who had been observed for the past 6 years. Sixteen 
      patients had dilated cardiomyopathy; 1, dilated hypertrophic cardiomyopathy; 3, 
      restrictive cardiomyopathy; and 2, ischemic cardiomyopathy; there were 15 males 
      and 7 females, and 6 of the 22 patients were children. The 22 patients were 
      divided into two groups according to their response to tailored medical therapy. 
      Group 1 (n = 6) consisted of those whose cardiac function improved to New York 
      Heart Association (NYHA) status 2 from NYHA status 3 or 4. Group 2 (n = 16) still 
      exhibited refractory heart failure. Seven of these 16 patients went on to have 
      successful HTX. Survival in groups 1 and 2 combined was significantly lower than 
      actuarial survival post-HTX cited in the registry of the International Society 
      for Heart and Lung Transplantation, and group 2 had an even lower survival than 
      the total groups 1 and 2 survival. Survival in children was much lower than that 
      in adults. Seven of the 16 patients in group 2 showed a genetic link, but there 
      was no genetic link in group 1 patients. One patient in group 2 had a panel 
      reactive antibody (PRA) value of 46% and died while awaiting HTX. Post-HTX care 
      in terms of immunosuppressant therapy, was modified for each patient. It is 
      particularly necessary to consider the time a patient will wait on the list for 
      candidates for HTX who are children, have a genetic link, or are positive for 
      PRA. A genetic approach is helpful to determine indications for HTX. Sensitive 
      monitoring of post-HTX immunosuppression is needed.
FAU - Nunoda, S
AU  - Nunoda S
AD  - Department of Internal Medicine, Kofu National Hospital, Yamanashi, Japan.
FAU - Kurosawa, R
AU  - Kurosawa R
FAU - Kogashi, K
AU  - Kogashi K
FAU - Yamagishi, S
AU  - Yamagishi S
FAU - Mitsui, F
AU  - Mitsui F
FAU - Funabashi, W
AU  - Funabashi W
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Heart Vessels
JT  - Heart and vessels
JID - 8511258
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiomyopathies/*surgery
MH  - Child
MH  - Disease Progression
MH  - Female
MH  - *Heart Transplantation/immunology/mortality
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Patient Selection
MH  - *Postoperative Care
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Analysis
EDAT- 1997/01/01 00:00
MHDA- 1998/02/26 00:01
CRDT- 1997/01/01 00:00
PHST- 1997/01/01 00:00 [pubmed]
PHST- 1998/02/26 00:01 [medline]
PHST- 1997/01/01 00:00 [entrez]
PST - ppublish
SO  - Heart Vessels. 1997;Suppl 12:37-40.