[Current aspects of human heart transplantation. II. Postoperative surveillance and results]

The cardiac transplantation program of the Pitié-Salpêtrière Hospital has, since October 1973, involved 17 transplants with 15 recipients. Seven patients are alive. Real progress has been achieved in all areas: --selection of the recipient, now more strict is dependent upon precise criteria; --choice of the donor should take into account the best possible tissue and haemodynamic compatibility; --immuno-depressive therapy involves the combination of corticosteroids, azathioprine, antilymphocytic globulins and heparin. It is varied as necessary in relation to episodes of rejection; --the diagnosis of rejection is based upon clinical, radiological and electrical criteria, but also upon new and precise haemodynamic and biological criteria; --long term control is facilitated by regular telephone transmission of the electrocardiogram. The prognosis remains reserved but with socio-professional rehabilitation to help in overcoming the initial slight degree of "hospitalism", the sensation of a new life is such that cardiac transplantation represents an acceptable solution in the treatment of certain cardiac diseases.