From July 1982 to November 1983 18 patients (one female) underwent orthotopic cardiac transplantation at the Texas Heart Institute. Prednisone and cyclosporin were used for maintenance immunosuppression in all patients. Cumulative follow up has now been for 90 patient months (0.75-20 months). Rejection occurred in 10 recipients (56%) and was fatal in three, giving an incidence of rejection of 0.6 episodes per recipient and a mortality rate of 30% per episode. At one year 39% of recipients were free of infection and 73% free of fatal rejection. Infection episodes occurred on 32 occasions in 14 patients and 24 episodes required treatment. There were no infection related deaths, although the first year actuarial freedom from infection rate was only 24%. With 14 of the 18 patients surviving (78%), an actuarial one year survival of 74%, and freedom from major complications in the short term, the efficacy of cyclosporin immunosuppression for cardiac transplantation is confirmed.
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