Cardiac Transplantation

Michael R. Mill Michelle S. Grady

TransplantRecipients

Cardiac Physiplpqy.after.Transplantatipn

Cardiac Evaluation of the Posttransplant Patient

Immunpsuppressipn.fp.r. Cardiac Transplantation

Rejection

Infectious Complications after Cardiac Transplantation Noninfectious Complications of Cardiac.. Transplantation Pediatric Cardiac Transplantation

Emergency Department...Eva.luation.. and. Treatment..of the. Posttransplant. .Patient Chapter. References

The first clinically successful cardiac transplant was performed in December 1967. Since then, advances in the immunosuppression and postoperative care of these patients have resulted in dramatically improved patient survival. This has been accompanied by a tremendous growth in the number of procedures performed. Data from the registry of the International Society of Heart and Lung Transplantation (ISHLT) and the United Network for Organ Sharing (UNOS) reveals that 45,993 heart transplants were performed at 301 centers throughout the world between January 1, 1983, and March 1, 1998.1 This total includes more than 2000 heart transplants per year in the United States since 1990. The actuarial survival after transplantation reported by UNOS is 85 percent at 1 year, with 3-year and 5-year actuarial survivals of 76 percent and 69 percent, respectively.2 Given the increased number of patients undergoing transplantation and their excellent long-term survival, these patients will come to the attention of physicians in the emergency department (ED) with increasing frequency.

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