[Follow-up of heart transplants]

6 patients, 37-55 years old, who underwent heart transplantation in Belgium, have been followed in our clinic for the past 2 years. All had suffered for 6-12 months from congestive heart failure which had not responded to intensive medical treatment and were considered terminal. 5 had had ischemic heart disease and 1 idiopathic dilated cardiomyopathy. After transplantation all patients were again in good physical condition and 5 of them had resumed a productive lifestyle. In 3, follow-up endomyocardial biopsies revealed episodes of "moderate rejection" of the transplant, all of which were successfully treated with pulse courses of corticosteroids and increased cyclosporine dosage. Mild renal failure developed in 3, and in 3 systemic hypertension, controlled by antihypertensive drugs. 4 patients examined in our department and found suitable for transplantation died before a compatible donor was found. In 2 other patients heart transplantation was not possible due to severe pulmonary hypertension. Heart transplantation is recommended for patients with terminal congestive heart failure unresponsive to medical treatment. Early transplantation prevents irreversible changes in the pulmonary vessels which would make operation impossible, and lowers operative risk.