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Updated: Aug 20, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
[Orthotopic heart transplantation: clinical experience on 56 patients]
Chun-sheng Wang1, Hao Chen, Tao Hong
1Department of Cardiothoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai Institute of Cardiovascular Diseases, Transplantation Center of Fudan University, Shanghai 200032, China.
Insights
Orthotopic heart transplantation demonstrated a 91% one-year survival rate in 56 patients. This study highlights the success of heart transplantation with careful patient selection and surgical techniques.
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Immunosuppression Therapy
Context:
- Orthotopic heart transplantation is a critical treatment for end-stage heart failure.
- This study reviews clinical experience from May 2000 to December 2003 at a major transplantation center.
- Patient indications included cardiomyopathy, valvular heart disease, ischemic heart disease, cardiac tumors, and arrhythmias.
Purpose:
- To summarize the clinical outcomes of 56 patients undergoing orthotopic heart transplantation.
- To evaluate the effectiveness of different surgical techniques and postoperative management.
Summary:
- 56 patients underwent orthotopic heart transplantation, utilizing conventional Stanford or bicaval anastomotic techniques.
- Postoperative immunosuppression involved combinations of cyclosporine A or FK506 with corticosteroids and MMF.
- The one-year survival rate was 91%, with survivors showing improved heart function (NYHA class I-II).
Impact:
- The findings suggest that meticulous recipient selection, donor heart management, surgical technique, and postoperative care lead to favorable mid-term results in heart transplantation.
- This contributes to the understanding of optimizing outcomes in cardiac transplant recipients.
Objective:
To summarize the clinical experience on 56 patients undergoing orthotopic heart transplantation.
Methods:
Between May 2000 and December 2003 56 patients, 47 with cardiomyopathy, 2 with end-stage valvular heart disease, 2 with end-stage ischemic heart disease, 2 with primary malignant cardiac tumor, 1 with complicated congenital heart disease, 1 with muscular dystrophy cardiomyopathy, and 1 with refractory malignant ventricular arrhythmias, underwent orthotopic heart transplantation in the Transplantation Center of Fudan University. The operative procedures included 19 conventional Stanford orthotopic cardiac transplantation in 19 cases and bicaval anastomotic cardiac transplantation in 37 cases. Postoperatively, the patients were prescribed with cyclosporine A + corticosteroids + MMF or FK506 + corticosteroids + MMF as anti-rejection therapy.
Results:
One patient undergoing his fifth operation died of bleeding 3 days after operation. All survivors were followed-up for 12.4 months on average. Five patients died within 1 year postoperatively with a one-year survival rate of 91%. One patient died of allograft vasculopathy 38 months after operation. Other patients enjoyed heart function recovering to class I-II (NYHA).
Conclusion:
With proper recipient selection, excellent donor heart conservation, bicaval anastomotic technique, and efficient postoperative surveillance and treatment, heart transplantion may produce satisfying mid-term results.
