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Related Experiment Videos

Heart transplantation in Berlin.

R Hetzer1, H Warnecke, M Loebe

  • 1Deutsches Herzzentrum Berlin, Stiftung des Burgerlighen Rechts, Germany.

Clinical Transplants
|January 1, 1989
PubMed
Summary

This study details 346 heart transplantations, primarily for dilated cardiomyopathy, achieving good results with evolving immunosuppression protocols. Advanced diagnostic methods like intramyocardial electrograms improved rejection detection safety.

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Area of Science:

  • Cardiology
  • Transplant Surgery
  • Immunology

Background:

  • Heart transplantation has become a routine procedure.
  • Dilated cardiomyopathy is the predominant diagnosis in patients undergoing heart transplantation.
  • Immunosuppression protocols have evolved over time.

Purpose of the Study:

  • To report the experience and outcomes of 346 heart transplantations.
  • To describe the current immunosuppression protocol and donor organ acceptance criteria.
  • To evaluate the effectiveness of diagnostic methods for rejection and outcomes in pediatric patients.

Main Methods:

  • Cyclosporine A, azathioprine, cortisone, and rabbit ATG for immunosuppression.
  • Acceptance of donor organs up to 55 years without coronary angiography.

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  • Diagnosis of rejection supplemented by intramyocardial electrograms and M-mode echocardiography.
  • Telemetric intramyocardial electrogram monitoring and M-mode echocardiography for rejection diagnosis.

    • Main Results:

    • 346 heart transplantations performed, with dilated cardiomyopathy in 64%.
    • Satisfying functional and late results with donor organs up to 55 years.
    • Improved diagnostic safety for rejection using electrograms and echocardiography.
    • 72% survival rate in 11 pediatric heart transplant recipients.
    • Successful bridge to transplantation program with 18 patients transplanted.

    Conclusions:

    • Evolving immunosuppression and diagnostic strategies enhance heart transplant outcomes.
    • Routine use of intramyocardial electrograms and echocardiography increases diagnostic safety.
    • Pediatric heart transplantation shows promising survival rates.
    • Bridge to transplantation and mechanical bridging are important future directions.