Prognosis after heart transplantation

doi:10.1136/bmj.326.7388.509

BMJ 2003;326:509-510 ( 8 March )

Editorials

Prognosis after heart transplantation

Transplants alone cannot be the solution for end stage heart failure

The first 150 words of the full text of this article appear below.

Heart transplantation is in its third decade as a widely accepted treatment for advanced heart failure. What is its prognosis?In the early era of heart transplantation, the perceived alternativeto transplantation was imminent death. In 1968, at the beginningof heart transplantation, Peter Medawar, the eminent zoologistand Nobel laureate whose work on tolerance set the scene for successfultransplantation, correctly predicted: "The transplantation ofhuman organs will be assimilated into ordinary clinical practice. . . and there is no need to be philosophical about it. Thiswill come about for the single and sufficient reason that peopleare so constituted that they would rather be alive than dead."¹

Heart transplantation has a high early mortality $---$ 15-20% of recipients die within a year of the operation. ² ³ Thereafterthe death rate is constant, at about 4% a year for the next 18years, so that 50% of patients can expect to be alive . . . [Full text of this article]

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