Heterotopic cardiac transplantation. A 7-year experience at Groote Schuur Hospital, Cape Town.

Between November 1974 and February 1982 40 patients underwent heterotopic heart transplantation at Groote Schuur Hospital, Cape Town. In 4 of these patients retransplantation was carried out, bringing the total number of heterotopic heart transplant operations to 44. Fourteen patients are alive to date, from 4 months to more than 7 years after transplantation. The 1-year survival rate has been 60%. Three of the first 6 patients in this series have survived for 6 years or more, while 6 of the 7 patients who received transplants during 1981 (including 2 who underwent retransplantation) are alive. Retransplantation of the donor heart, donor heart procurement from distant sources using prolonged myocardial preservation techniques and the reasons why heterotopic cardiac transplantation is more advantageous than other methods are discussed. The surgical technique and some modifications introduced since this method was first described in 1975 are presented in detail.