Survival following cardiac transplantation--what are acceptable standards?

In an 18-month period, 50 orthotopic cardiac transplantations were done in Utah in 48 patients with end-stage heart failure. The 12-month actuarial survival was 98%, indicating that successful cardiac transplantation can be done in a newly established program and that the intermountain West has an adequate supply of potential recipients and donors for a moderate- to high-volume program. Furthermore, the administration of cardiac transplantation in a setting of other treatment modalities of heart failure in a multi-institutional program that crosses private practice-academic barriers is feasible. Results such as these need to be considered by the federal government as it establishes eligibility criteria for centers to be approved for Medicare-funded cardiac transplantation.