Clinical transplantation of the heart: a review of 13 years' personal experience.

The results of the heart transplantation operations performed personally by one surgeon (CNB) at Groote Schuur Hospital between 1967 and 1980 are reviewed. Of 9 orthotopic transplants performed between 1967 and 1973, 4 survived for more than one year and 2 remain alive today twelve and ten years later. Of 11 heterotopic transplants performed since 1974, one-year patient survival has been 82%, though one patient survived on his own heart after irreversible graft rejection. Three of the original 4 patients remain alive over five years later. These results are rather better than the overall results of our unit, where a total of 37 heterotopic transplants has been performed; the possible reasons for this are discussed. One patient, previously unreported, who underwent transplantation of the heart and both lungs in 1971, died after 23 days from pulmonary complications. Heterotopic transplantation using a xenograft (baboon or chimpanzee heart) has been performed on two occasions as a means of temporary circulatory support in patients with acutely failing hearts when no human donor was available. The chimpanzee heart supported the circulation satisfactorily for four days.