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Orthotopic Cardiac Transplantation in a Veterans Administration Hospital

Szabolef Szentpetery, MD; Mitchell H. Goldman, MD; Daniel Woody, MD; Josephine Salim; Thalachallour Mohanakumar, PhD; Richard Lower, MD
Arch Surg. 1984;119(4):390-393. doi:10.1001/archsurg.1984.01390160026006.
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• 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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