[Orthotopic heart transplantation: a case report].

In July 1994, we performed orthotopic heart transplantation for a patient with hypertrophic myocardiopathy, who had had open heart surgery enlarging the right ventricular outlet. The patient had an excellent postoperative result. He received triple-drug immunosuppressive therapy. Large dose of methyl-prednisolone was used successfully for his acute rejection reaction. At present, the patient is living well with good cardiac, hepatic and renal function. We described donor heart harvest, myocardial protection, operative procedure, immune monitoring, anti-rejection and anti-infectious therapy. We introduced the process of protecting donor heart on the way to hospital by retrograde perfusion with medium hypothermic oxygenated-blood combined with St. Thomas cardioplegia. Besides endomyocardial biopsy, other noninvasive examinations such as noninvasive cardiac output monitoring could be helpful to monitor acute rejection reaction.