Managing complications in heart transplant recipients. Improved techniques and medications increase survival rates.

Major problems facing cardiac transplant recipients include rejection, infection, and transplant coronary artery disease. Commonly used antirejection drugs are high-dose corticosteroids and cytolytic agents. Bacterial infections, such as those caused by staphylococci, occur early in the postoperative period, while opportunistic infections, including viral, fungal, and parasitic diseases, occur several weeks after transplant surgery. Coronary angiography is used to detect transplant coronary artery disease, the only definitive treatment for which is retransplantation. A number of promising new immunosuppressive agents and techniques may prevent some complications and further improve the care cardiac transplant recipients receive.