Cardiac transplantation: clinical experience of the first 150 patients at the alfred hospital

Aims: To report the clinical experience of the first 150 patients undergoing cardiac transplantation at the Alfred Hospital from February 1989 to March 1993. Methods: Major indications were idiopathic dilated cardiomyopathy (47%) and ischaemic heart disease (36%). Results: Of 433 patients referred, 242 (56%) were accepted onto the waiting list, of whom 150 (62%) received cardiac transplants. Median time on the waiting list was 42 days. Acute rejection was seen in 125 patients (83%). Transplant coronary disease was diagnosed in 16 patients (14%) who underwent coronary angiography. Infection was a major contributor to morbidity. During the follow-up period, 23 patients (15%) died. Eight patients (5%) died within 30 days of the surgery. Actuarial survival was 88% at 1 year and 82% at 4 years. Conclusion: Cardiac transplantation continues to evolve as an increasingly successful option for patients with end-stage cardiac disease.