Symptom distress in cardiac transplant candidates.

Objective: To examine symptom frequency and distress in heart transplant candidates.

Design: Prospective, two-site study with a correlational design.

Setting: Large Midwestern and large Southern medical center.

Cardiac adaptation to obesity and hypertension after heart transplantation.

Obesity and hypertension frequently develop after heart transplantation. The cardiac adaptation to obesity and hypertension was studied by determining hemodynamic and echocardiographic indexes in 10 obese hypertensive patients (body mass index greater than or equal to 27.8 kg/m2 in men or greater than or equal to 27.

Oversizing of donor hearts: beneficial or detrimental?

To determine the effects of donor/recipient weight mismatch on allograft function and survival after orthotopic heart transplantation, we retrospectively compared the clinical and the hemodynamic characteristics of recipients weighing more than their donor ("undersized") with those of recipients weighing less than their donor ("oversized"). The median follow-up period was 24 months (range, 0 to 67 months). In 88 patients (59%) donor weight was 1% to 46% less than recipient weight (13.

Predictors of hospital length of stay after heart transplantation.

Factors that predict hospital length of stay after heart transplantation were identified from retrospective data of 65 patients (82% male, mean age, 43.3 years). Multiple regression analysis with a stepwise procedure was used to generate three predictive models for length of stay: (1) a model to be used before operation, (2) a model that combines preoperative and donor information, and (3) a model that takes preoperative, donor, and postoperative factors (complete model) into consideration.

Reversal of recalcitrant cardiac allograft rejection with methotrexate.

Refractory cardiac transplant rejection is a major therapeutic dilemma. The effectiveness of methotrexate (MTX) in autoimmune diseases prompted us to explore its efficacy in 10 cardiac transplant recipients, aged 20-53 years (39 +/- 13 years; mean +/- SD), with biopsy evidence of drug-refractory cardiac allograft rejection. Nine cardiac transplant recipients were maintained on triple antirejection therapy (cyclosporine, azathioprine, and prednisone), and the remaining recipient was maintained on cyclosporine and prednisone.