[Cardiac retransplantation (42 cases in 38 patients). Indications and outcome]

In order to determine the results of cardiac retransplantation 38 cases were reviewed (42 transplantations; 4 patients underwent 3 transplantations). Clinical indications included acute rejection and infection before and after retransplantation: the explanted heart was sent for anatomopathological study. The indications were dominated by coronary artery disease of the graft (26 cases) with an average of 45.3 months between the two transplantations and a long-term survival comparable to that of primotransplantation. Conversely, in the other indications of retransplantation, the delay was much shorter (less than 12 days in half the cases) and the results were poor (9 deaths out of 12 cases). Therefore, coronary disease of the graft would seem to be the only justified indication for retransplantation at it associates stable haemodynamic conditions and therapeutic impregnation comparable to the primotransplantation.