A randomized, controlled trial of C0- Vs C2-guided therapeutic drug monitoring of cyclosporine in stable heart transplant patients.

Background: Cyclosporine monitoring using 2-hour post-dose samples (C2) is thought to be more efficacious than using pre-dose levels (C0) in managing immunosuppression for transplant patients. We evaluated the effect of C2 monitoring on cyclosporine dose and clinical parameters in stable heart transplant patients.

Methods: 125 stable heart transplant patients were randomized to C0 or C2 monitoring of cyclosporine levels for a period of six months.

Pre-existing renal failure doubles 30-day mortality after heart transplantation.

Background: Survival after cardiac transplantation has not changed over the last 10 years. Our objective was to identify risk factors for 30-day mortality after cardiac transplantation with particular reference to focusing on the impact of pre-existing renal dysfunction.

Methods: We analyzed the data of all 1,180 patients who received a first heart transplant in the 8 adult transplant centers in the United Kingdom between April 1996 and March 2002 using the UK Cardiothoracic Transplant Audit database.

A prospective controlled trial of St. Jude versus Starr Edwards aortic and mitral valve prostheses.

Background: There is a paucity of controlled trials comparing the merits of different heart valve prostheses. In this prospective randomized trial we compared Starr Edwards and St. Jude prostheses in the aortic and mitral positions.

An economic evaluation of lung transplantation.

Objective: This study was undertaken to determine the cost per quality-adjusted life-year gained with lung transplantation relative to medical treatment for end-stage lung disease in the United Kingdom.

Methods: Patients on the transplant waiting list were used to represent medical treatment. Four-year national survival data were extrapolated to 15 years by means of parametric techniques.