Cardiac transplantation. University of Miami/Jackson Memorial Hospital experience.

Cardiac transplantation at the University of Miami/Jackson Memorial Medical Center began in November 1986. Up to April 1993, 220 potential recipients were evaluated and 84 accepted. Sixty-three patients received transplants while 14 died awaiting a donor heart. Within six years, the average recipient age has increased from 40 to 59 years. The overall one, two, and five-year survival rates (including operative deaths) are 89.5%, 82%, and 76%, respectively. Postoperative complications and mortality were related to infection or rejection frequently encountered within the first 28 months; thereafter the actuarial survival curve showed minimal decay and the complication rate declined. One or more hospital readmissions were needed in 38 of 57 (67%) survivors. Among the 50 long-term survivors, 42% are working and 84% are in New York Heart Association functional Class I.