Heart transplantation — Status in Europe

Summary

Heart transplantation (Tx) started in Europe in March 1968 in our group in La Pitié, which performed the seventh cardiac Tx in the world. So far, more than 3000 such operations have been performed in Europe by more than 120 centers. The main problem remains the shortage of donors, which cannot match the needs, and which necessitates a careful selection of the recipients, avoiding patients with infection, too high pulmonary hypertension, or an age of over 60 years. Orthotopic Tx is the most frequent technique used, and the main postoperative problems are: hemodynamic instability during the first week; rejection, detected by endomyocardial biopsy and now various noninvasive methods; and the side effects of the immunosuppressive drugs (cyclosporine, azathioprine, corticoids, antilymphocyte globulin (ALG), or OKT3 monoclonal antibody). The overall survival rate at 7 years is 65%, with full rehabilitation of the survivors.