PMID: 2113095May 1, 1990Paper

Induction immunosuppression for patients bridged to transplantation

The Journal of Heart Transplantation
R W EmeryM R Pritzker

Abstract

From January 1987 through July 1989, nine patients (eight male, one female) underwent bridge to transplantation and were managed with a modified immunosuppression regimen based around the monoclonal antibody OKT3. Six patients were bridged with the Jarvik-7 70 cc total artificial heart, four patients with centrifugal ventricular assist devices, and one patient with a Novacor left ventricular assist system. In two patients two devices were used. There was one patient death at 29 days after transplantation because of acute rejection. One other patient had a rejection episode 368 days after transplantation, for an overall rejection incidence of 0.22 episodes/patient. Four infections occurred, and all were viral--three cytomegalovirus and one mumps. Posttransplant complications involving other organ systems were minimal. In follow-up, from 2 to 29 months, six patients are in New York Heart Association functional status class I and one is in class II. Six patients are not taking steroids. The serum cholesterol level in the patients not receiving steroids at 6 and 12 months is 151 +/- 11 and 171 +/- 23 mg/dl (+/- SEM), respectively. Because of these results we have expanded our indications for the modified regimen using OKT3 in patie...Continue Reading

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