[Heart transplantations. Current status. Experience at the Hôpital de la Pitié]

The experience gathered over the last fifteen years of clinical application of heart transplants has resulted, in the last two years, in much improved results:the survival in our series is 77% at one year and 70% at 2 years. This progress is due to the following factors:improved patient selection, with strict respect of contraindications, in particular, patients over the age of 50 and patients with advanced multi-system failure; improved selection of donors, avoiding, within the limitations of immunological compatibility, grafts in poor condition from subjects over the age of 35 and a refinement of the operative techniques, especially the introduction of more potent immuno-suppressants such as Cyclosporin A and improved post-operative monitoring based on immunological examinations and repeated endo-myocardial biopsies. These advances will lead to a broadening of the operative indications and a wider use of this form of treatment.