Peripheral vascular involvement in heart transplant patients.

Between 1984 and 1991 a total of 200 patients underwent heart transplantation in our unit. The records of 121 patients who were followed up for more than 1 year were reviewed for peripheral vascular abnormalities, which were found in 12 (9.9%). Most of these patients underwent transplantation for ischemic heart disease, and peripheral vascular disease preceded the heart transplantation in 80%. Although surgical risks are low in this setting, particular caution should be exercised to prevent septic complications in the femoral triangle. Among the risk factors studied, only elevated blood cholesterol was frequently found in the vascular patients before or after transplantation. Peripheral vascular involvement in heart transplant patients corresponds to the natural course of atheroma rather than to an accelerated process of atherosclerosis.