Cardiac transplantation: indications, procurement, operation, and management.

Between July 1982 and April 1984, 22 patients underwent cardiac transplantations at the Texas Heart Institute with a cumulative follow-up of 188 patient-months (mean of 8.6 months and a range of 0.5 to 21). The actuarial survival rate at 20 months was 72%. Strict selection criteria for potential recipients and donors, optimal perioperative management, which includes endomyocardial biopsy, and most important the introduction of cyclosporine are the major factors that led to these increasing survival rates. The high incidence of cyclosporine-related complications, especially hypertension and myocardial fibrosis, will require long-term evaluation to adequately assess the therapeutic effectiveness of this new immunosuppressive agent.