[Follow-up of twelve cases of heart transplantation]

To observe the effects of heart transplantation.

Twelve patients undergoing orthotopic heart transplantation, one of which underwent combined heart and kidney transplantation (HKT), from June 1997 to June 2002 were followed up to observe the complications, work ability, life quality and psychic status.

One of the 12 patients died of acute rejection and one died of acute renal failure during perioperative period. Ten cases (83.3%) survived the operation. Then one of the 10 patients died of acute rejection due to stopping Cellcept 7 months after operation; and the other 9 patients had lived well for 1 to 9 years, of which one recipient undergoing HKT survived for nearly 3 years. One year after operation the 9 patients showed class I heart function (NYHA), and all resumed their original work. One patient suffered from schizophrenia 1 week after operation. After the operation every year all cases were to receive coronary angiography with the results showing thinner coronary artery and less lateral branches, and myocardium, emission computed tomography (ECT) scanning that revealed local ischemia in anterior or posterior myocardium in 2 cases 4 and 5 years after respectively, however, no symptom of coronary artery disease was seen in all patients. Two cases, including the one receiving HKT, had symptoms of diabetes mellitus. Two patients thoracotomy during the perioperative period because of cardiac tamponade or too much blood drainage. All cases suffered from right heart failure, mouth ulcer and hypertension due to taking CsA and they had to take antihypertension drug to control their blood pressure. No malignant tumor had been found.

Heart transplantation is an effective treatment for end-stage dilated cardiomyopathy. But many complications may follow. Some of them may endanger patients' life, and others may affect the quality of life. To trace the patients closely and deal with various complications in time will improve the effect of cardiac transplantation.