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Is Cardiac Transplantation in Children an Experimental Procedure?

Am J Dis Child. 1986;140(11):1105-1106. doi:10.1001/archpedi.1986.02140250031028.
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Since Dr Christiaan Barnard's first cardiac transplant in a human adult, cardiac transplantation has become an almost commonplace and accepted procedure with every expectation for long-term success, with a one-year survival rate of 80%,1 a three-year survival rate of 72%, and a five-year survival rate of 50%. These survival rates are expected to improve based on the three-year data collected since the use of cyclosporine began (actuarial data from Jack G. Copeland, MD, oral communication, July 1986). The most common indication for cardiac replacement in adults is congestive cardiomyopathy from myocarditis or end-stage coronary artery disease. The greatest management problem is immunologic rejection of the transplanted heart, which is now managed much more easily in conjunction with corticosteroids since the drug cyclosporine has become available.2

Translation of the adult experience to the pediatric patient has not been direct for many reasons. First, children have seldom been in a


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