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April 1984

Orthotopic Cardiac Transplantation in a Veterans Administration Hospital

Author Affiliations

From McGuire Veterans Administration Medical Center (Drs Szentpetery, Goldman, and Woody and Ms Salim) and the Medical College of Virginia, Virginia Commonwealth University (Drs Mohanakumar and Lower), Richmond.

Arch Surg. 1984;119(4):390-393. doi:10.1001/archsurg.1984.01390160026006

• Of 57 patients referred to the McGuire Veterans Administration Medical Center, Richmond, Va, for evaluation for cardiac transplantation, 18 received allografts. The overall graft survival rate was 67% from two to 24 months after transplantation. In 15 recipients receiving immunosuppression with rabbit anti—human thymocyte globulin, prednisone, and azathioprine, previous transfusion and HLA-DR matching resulted in improved graft survival. In three patients receiving cyclosporine and prednisone, hypertension, nephrotoxicity, and hepatotoxicity were seen. All surviving recipients were in functional New York Heart Association class 1 or 2. The cost to the Medical Center was $23,275 per transplant. The results achieved at the center suggested that a regionalized cardiac transplant program can be established within the VA health care system with acceptable clinical results and significant financial savings.

(Arch Surg 1984;119:390-393)

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