References of "Defraigne, Jean-Olivier"
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See detailAttitude of a Young Surgeon toward Experimental Surgery. Roles and Limits of Experimental Surgery
Defraigne, Jean-Olivier ULg

in Acta Chirurgica Belgica (1995), 95(2, Mar-Apr), 113-7

At the moment, the place of experimental surgery within the clinical surgical cores is questioned. However, its role in the progresses of surgical practice and training of surgeons is undisputable. It is ... [more ▼]

At the moment, the place of experimental surgery within the clinical surgical cores is questioned. However, its role in the progresses of surgical practice and training of surgeons is undisputable. It is through research that surgeons can keep some critical mind, essential in their daily activities. However, too often actually, the surgeons abandon research. Two essential reasons explain the phenomenon: on the one hand, the weight of the clinical tasks and on the other hand the complexity of research founded on more and more specialized basic notions. In fact, the part of a surgical investigator must be to form a link between basic research and clinical activities. As such, work in collaboration with motivated basic investigators is cardinal. Also, the success of research depends upon the will of the departments to maintain a research activity, but it meets often with the difficulty in obtaining sufficient research credits. Finally, research can play an essential part in the education of the trainees and partly fill some gaps in their clinical training. [less ▲]

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See detailValve Replacement for Acute Left Heart Endocarditis
Detry, Olivier ULg; Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Cardiovascular Surgery (1995), 3(5), 529-35

Between January 1982 and June 1993, 66 patients (48 men and 18 women of mean (range) age 50 (21-77) years) underwent valve replacement for acute infective endocarditis. There were 45 aortic valve and 17 ... [more ▼]

Between January 1982 and June 1993, 66 patients (48 men and 18 women of mean (range) age 50 (21-77) years) underwent valve replacement for acute infective endocarditis. There were 45 aortic valve and 17 mitral valve infections. Four patients had bivalvular involvement. Fifty-three patients suffered from native valve endocarditis, with underlying valvular lesions documented for 31 patients. Staphylococci and Streptococci spp. were responsible for 68% of infection, and 20% of blood and valve cultures were negative. Refractory congestive heart failure was the leading surgical indication in 86% of patients. The mean follow-up period was 44 months. The perioperative mortality rate was 6%. Actuarial survival rates were 88.5% at 1 year and 83% at 3 years. No early recurrence of infection was noted. Six patients (9%) needed reoperation. Satisfactory results confirm that early surgical management should be considered in patients with complicated infective endocarditis. [less ▲]

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See detailEffects of PEEP on systemic vascular compliance in intact pigs
LAMBERMONT, Bernard ULg; DETRY, Olivier ULg; FOSSION, A et al

in Pflügers Archiv : European Journal of Physiology (1995), 430

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See detailSuccessful abdominal aortic aneurysm resection in long-term survivors of cardiac transplantation.
Defraigne, Jean-Olivier ULg; SAKALIHASAN, Natzi ULg; DEMOULIN, Julie ULg et al

in Cardiovascular Surgery (1995), 3(3), 321-4

With the improvement of survival rates following cardiac transplantation, the probability of recipients developing extracardiac disease is increased. Three cases are reported of abdominal aortic aneurysm ... [more ▼]

With the improvement of survival rates following cardiac transplantation, the probability of recipients developing extracardiac disease is increased. Three cases are reported of abdominal aortic aneurysm successfully operated on in cardiac allograft recipients 1 to 4 years after transplantation. Indications for transplantation were valvular, idiopathic and ischaemic cardiomyopathy. Post-transplant hypertension and hyperlipidaemia may have played a role in the rapid growth of the aneurysms. Cardiac function and the incidence of graft atherosclerosis were assessed before surgery by coronary angiography. All three patients were discharged from hospital. Abdominal aortic aneurysm resection may be a safe procedure in cardiac transplant patients. In view of the rapid increase in the size of the aneurysms in transplanted patients, careful screening should be performed during follow-up. [less ▲]

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See detailPacemaker Implantation for Early Sinus Node Dysfunction after Orthotopic Heart Transplantation
RADERMECKER, Marc ULg; Defraigne, Jean-Olivier ULg; Fourny, J. et al

in Acta Chirurgica Belgica (1995), 95(1), 31-4

Among 60 patients who received OHT at our institution between November 1986 and January 1990, 4 actually needed implantation of a permanent pacemaker. Three patients with symptomatic early sinus node ... [more ▼]

Among 60 patients who received OHT at our institution between November 1986 and January 1990, 4 actually needed implantation of a permanent pacemaker. Three patients with symptomatic early sinus node dysfunction were identified and were satisfactorily paced on the VVIR mode. All three showed sinus recovery within three months following implantation and had their pacemaker switched from the VVIR mode to a simple ventricular demand pacing. Interestingly, administration of beta-blocking drugs quickly reinstituted pace dependence. The patients' outcome is excellent (18 to 48 months follow-up). No difference with the global cohort of our OHT recipients was noticed, apart from an apparent high incidence of infections (3/3) with (2/3) CMV and severe rejection (3/3) during the first month postoperatively. This data suggests that sinus dysfunction may be the result of a multifactorial (rejection, CMV, ...) injury to the conduction system, and is only clinically relevant beyond a threshold level. Denervation hypersensitivity, together with correction of these factors, may account for the restoration of a sufficient reserve of conduction system, and therefore appropriate sinus node function in basal conditions. [less ▲]

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See detailLa thrombose veineuse profonde des membres supérieurs. Revue de la littérature. A propos d'un cas de syndrome de Paget-Schrotter
Defraigne, Jean-Olivier ULg; Remy, D.; Limet, Raymond ULg

in Revue Médicale de Liège (1995), 50(8), 336-46

Un cas de thrombose veineuse profonde (TVP) du membre supérieur survenue dans le contexte d'un effort chez un sujet jeune (syndrome de Paget-Schrötter) est présenté. La TVP des membres supérieurs présente ... [more ▼]

Un cas de thrombose veineuse profonde (TVP) du membre supérieur survenue dans le contexte d'un effort chez un sujet jeune (syndrome de Paget-Schrötter) est présenté. La TVP des membres supérieurs présente des caractéristiques étiologiques et physiopathologiques différentes de celles de la TVP des membres inférieurs. On distingue des phlébites primaires et secondaires. La phlébite primaire survient généralement chez des sujets plus jeunes, et une notion d'effort est fréquemment retrouvée. Les phlébites secondaires s'observent dans différentes circonstances: mise en place de cathéters ou de sonde de pacemaker, affections néoplasiques, troubles de l'hémostase... Certaines controverses thérapeutiques existent, et, notamment, sur la nécessité de recourir ou non à la fibrinolyse et, dans les phlébites d'effort qui rentrent dans un contexte de syndrome du défilé costo-claviculaire, sur l'utilité de proposer un traitement chirurgical, en vue de lever la compression extrinsèque et/ou de reperméabiliser la veine. [less ▲]

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See detailIsolated Atherosclerotic Aneurysms of the Iliac Arteries
Desiron, Quentin ULg; Detry, Olivier ULg; Sakalihasan, Natzi ULg et al

in Annals of Vascular Surgery (1995), 9(Suppl), 62-6

Atherosclerotic aneurysms limited to the iliac arteries are rare and entail a high risk of rupture. To evaluate the efficacy of prophylactic surgery, we retrospectively studied 15 patients (13 men and two ... [more ▼]

Atherosclerotic aneurysms limited to the iliac arteries are rare and entail a high risk of rupture. To evaluate the efficacy of prophylactic surgery, we retrospectively studied 15 patients (13 men and two women; mean age 69 years) treated for isolated iliac aneurysms in the Department of Cardiovascular Surgery at the University Hospital of Liege over a period of 18 years. They had a total of 25 aneurysms (20 common iliac and five internal iliac). Six patients were treated electively and nine on an emergency basis for rupture. Five of the emergency patients (33%) died in the early postoperative period (< 30 days); in each case the aneurysm had ruptured and an emergency operation was performed (55.5% mortality in the ruptured iliac aneurysm group). On the other hand, all patients treated electively survived. Our study is comparable to other recent series in the literature, which also reported a high incidence of rupture and death in emergency operations. Prophylactic elective surgery is recommended for iliac aneurysms. [less ▲]

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See detailPreservation of Cortical Microcirculation after Kidney Ischemia-Reperfusion: Value of an Iron Chelator
Defraigne, Jean-Olivier ULg; Pincemail, Joël ULg; Detry, Olivier ULg et al

in Annals of Vascular Surgery (1994), 8(5), 457-67

Treatment of suprarenal aneurysms and renal artery reconstructions are both responsible for normothermic ischemia of the kidney (during clamping) followed by reperfusion (declamping). During reflow ... [more ▼]

Treatment of suprarenal aneurysms and renal artery reconstructions are both responsible for normothermic ischemia of the kidney (during clamping) followed by reperfusion (declamping). During reflow through an organ undergoing ischemia the production of free radicals can be associated with cell injury and a no-reflow phenomenon characterized by perfusion defects after a period of transient hyperemia. The objectives of this study were to demonstrate the existence of this phenomenon in the kidney undergoing ischemia followed by reperfusion and to test the potential protection afforded by an iron chelator (desferrioxamine) since free radical reactions are catalyzed by iron. Adult New Zealand white rabbits were divided into the following three groups: group A, 15 minutes of ischemia plus 10 minutes of reperfusion; group B, 60 minutes of ischemia plus 10 minutes of reperfusion; and group C, 60 minutes of ischemia plus 10 minutes of reperfusion combined with infusion of desferrioxamine (50 mg/kg). Cortical microcirculation in the kidney was measured by laser Doppler flowmeter before ischemia and 1, 5, and 10 minutes after reperfusion. Vitamin E content was determined in the cortex of the left kidney after 10 minutes of reperfusion and compared with that of the right (control) kidney. After 1 minute of reperfusion the cortical microcirculatory flow was significantly increased in all three groups (reactive hyperemia). In groups A and C blood flow returned to preclamping values after 10 minutes of reperfusion; however, blood flow in group B remained significantly reduced (29.2% +/- 10.5%) after 5 minutes of reperfusion with a further reduction to 48.5% +/- 5.7% after 10 minutes. These findings were correlated with the dosage of vitamin E since the vitamin E content was greatly reduced by 46.7% +/- 7.8% in group B but did not change significantly in groups A and C. This study shows that 60 minutes of normothermic ischemia is followed by a significant reduction in cortical microcirculatory flow (no-reflow phenomenon). Infusion of an iron chelator (desferrioxamine), however, which decreases the intensity of lipid peroxidation induced by the free radicals, preserves the microcirculatory flow. [less ▲]

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See detailDirect Evidence of Free Radical Production after Ischaemia and Reperfusion and Protective Effect of Desferrioxamine: Esr and Vitamin E Studies
Defraigne, Jean-Olivier ULg; Detry, Olivier ULg; Pincemail, Joël ULg et al

in European Journal of Vascular Surgery (1994), 8(5), 537-43

After surgical renal revascularisation, warm renal ischaemia due to renal artery cross-clamping contributes to postoperative renal dysfunction. After reperfusion, free radicals are thought to be a ... [more ▼]

After surgical renal revascularisation, warm renal ischaemia due to renal artery cross-clamping contributes to postoperative renal dysfunction. After reperfusion, free radicals are thought to be a significant cause of injury. Nevertheless, indisputable proof of free radical production is scarce, partly because of their transient nature. In this study, electron paramagnetic resonance and vitamin E levels were used to demonstrate the free radical production after renal ischaemia and reperfusion. Rabbit kidneys were submitted either to 15 or 60 minutes of ischaemia followed by reperfusion. A spin trap agent (alpha-phenyl-N-tert-butyl nitrone (PBN), 20mg/ml, 1 ml/min) was infused during reperfusion directly into the left renal artery via an aortic catheter before declamping. Blood samples were selectively drawn from the left renal vein for ESR analysis (Varian spectrometer E109) of lipidic residues extracted from blood samples. The vitamin E content of the left renal cortex was determined by HPLC procedure. The right renal cortex was used as a control for the vitamin E values. In the venous effluent, ESR analysis revealed the formation of a spectrum consisting of a triplet of asymmetric doublets. This signal resulted from the spin trapping by PBN of a mixture of both oxygen- and carbon- centred lipidic radicals. The amplitude of the signal which is proportional to the amount of free radicals was significantly higher after 60 minutes ischaemia than after 15 minutes.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailTransplantations de tumeurs malignes insoupçonnées lors de greffes d'organes
Detry, Olivier ULg; Detroz, Bernard ULg; D'Silva, M. et al

in Revue Médicale de Liège (1994), 49(1), 23-31

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See detailEvidence for Free Radical Formation During Human Kidney Transplantation
Pincemail, Joël ULg; Defraigne, Jean-Olivier ULg; Franssen, Christine ULg et al

in Free Radical Biology & Medicine (1993), 15(3), 343-8

Fourteen patients undergoing kidney transplantation were studied for evidence of the production of free radicals as assessed by the measurement of vitamin E (an index of lipid peroxidation) and of ... [more ▼]

Fourteen patients undergoing kidney transplantation were studied for evidence of the production of free radicals as assessed by the measurement of vitamin E (an index of lipid peroxidation) and of myeloperoxidase (a marker of neutrophil activation) in the systemic blood. Early (2 min) and late revascularization (30 min) of the kidney were respectively associated with a significant decrease of 35.5 and 40% of the initial level of plasma vitamin E. This consumption paralleled to the decrease of the vitamin E/total lipids ratio, a better indicator of vitamin E status. Heparin administration preceding renal artery clamping resulted in a twofold significant increase of baseline plasma myeloperoxidase (MPO) level (523 +/- 214 ng/ml). At kidney reperfusion, MPO concentration rose again and reached a maximum value of 1,653 +/- 882 ng/ml, indicating the presence of considerable neutrophil activation. A return to the baseline value was observed after 30 min of reperfusion. A short discussion about the possible origin of this MPO increase is given. Taken together, these data strongly suggest that free radical production, leading to lipid peroxidation phenomena, can occur within the early phase of kidney revascularization. Preliminary data using electron spin resonance with the spin-trapping technique strengthen this hypothesis. [less ▲]

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See detailMisdiagnosed Malignancy in Transplanted Organs
Detry, Olivier ULg; Detroz, Bernard ULg; D'Silva, M. et al

in Transplant International (1993), 6(1), 50-4

The case reports of three patients who received cancer-bearing organs at this institution are presented. A fourth recipient, who was to be transplanted with a cancerous kidney, was spared this disastrous ... [more ▼]

The case reports of three patients who received cancer-bearing organs at this institution are presented. A fourth recipient, who was to be transplanted with a cancerous kidney, was spared this disastrous complication. The relevant data regarding the donors is also alluded to, with special reference to the type and site of the primary malignancy. Following these case reports, the implications of these issues, their possible prevention, and further management are discussed. [less ▲]

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See detailAneurysm of the Ascending Aorta after Cardiac Transplantation
Defraigne, Jean-Olivier ULg; Vahdat, Olivier; LAVIGNE, Jean-Paul ULg et al

in Annals of Thoracic Surgery (1992), 54(5), 983-4

We report the case of a 57-year-old female cardiac transplant patient in whom an aneurysm of the recipient side of the ascending aorta developed 1 year after transplantation. Although a mycotic origin was ... [more ▼]

We report the case of a 57-year-old female cardiac transplant patient in whom an aneurysm of the recipient side of the ascending aorta developed 1 year after transplantation. Although a mycotic origin was the likely cause, histologic examination diagnosed an atherosclerotic aneurysm. [less ▲]

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See detailBrachiocephalic Arterial Reconstruction
VAN DAMME, Hendrik ULg; Caudron, D.; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1992), 92(1), 37-45

From 1980 to 1990, 18 patients underwent trans-sternal repair for occlusive disease of the brachiocephalic artery. The mean age was 57 years (43-72). Most of the patients were women (n = 10). All but two ... [more ▼]

From 1980 to 1990, 18 patients underwent trans-sternal repair for occlusive disease of the brachiocephalic artery. The mean age was 57 years (43-72). Most of the patients were women (n = 10). All but two patients had one or more symptoms related to the stenosis of the brachiocephalic trunk: right-sided upper limb ischemia (n = 7), transient ischemic attacks (n = 8), vertebrobasilar insufficiency (n = 6), left sided minor stroke (n = 1). Only two patients were asymptomatic before operation. Angiography revealed a tight stenosis (n = 14) or an occlusion (n = 3); in one patient it concerned an ulcerated non-stenotic plaque of the brachiocephalic artery. Eleven patients had coexistent involvement of other supraaortic vessels. Angiographically, clinically and intraoperatively, there was evidence of Takayasu arteritis in three female patients. All patients had direct repair by trans-sternal approach. Six patients with short lesions had thromboendarterectomy with patch angioplasty of the innominate artery. In eleven cases, aorto-brachiocephalic bypass grafting was performed. In one patient, aortic calcification precluded proximal anastomosis, and a carotid-to-carotid bypass was done. In five patients, simultaneous revascularization of subclavian (n = 3), left common carotid (n = 2) or internal carotid artery (n = 2) completed the procedure. In one patient, concomitant coronary revascularization was done. There was no operative mortality. Postoperative morbidity was limited to pulmonary infection (n = 2), transient neurologic deficit (n = 1) and renal insufficiency (n = 1). All patients had relief of symptoms. Duplex echo scan confirmed patency of all reconstructions at a mean follow-up of 46 months.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailEvidence for free radical generation in ischemia-reperfusion
Franssen, Colette ULg; Pincemail, Joël ULg; Defraigne, Jean-Olivier ULg et al

in Teaching and research in intensive care medicine - Proceeding book (1992)

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See detailAxillounifemoral and Axillobifemoral Bypasses. Retrospective Study of 85 Cases
DUJARDIN, P.; LAVIGNE, Jean-Paul ULg; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1991), 91(4), 155-60

From 1983 to 1990, 65 axillobifemoral and 20 axillofemoral bypasses have been performed in 85 patients (77 men and 8 women), with a mean age of 69 +/- 9 years. Indications for surgery were: severe ... [more ▼]

From 1983 to 1990, 65 axillobifemoral and 20 axillofemoral bypasses have been performed in 85 patients (77 men and 8 women), with a mean age of 69 +/- 9 years. Indications for surgery were: severe aortoiliac occlusive disease (87%), sepsis of previous aortoiliac prosthesis, abdominal aorta aneurysm. Anatomic bypass was precluded for general (81%) or local (19%) conditions. In the last group, 9 patients have had previous laparotomy. Four patients presented with aortoenteric fistulas. Eighteen patients were operated on in emergency. The operative mortality was 12%, with 50% cardiac related deaths. Early primary patency was 98%. Early secondary patency was 100%. The mean follow-up is 28 +/- 15 months. The 3 years survival is 77%. The cumulative patency rates at 1 and 3 years are 89% and 76% respectively. Although axillobifemoral bypasses achieve poor long-term results when compared with aortoiliac bypasses, they can be considered in high risk patients. In this group of patients, the cumulative patency rate and the survival curves tend to be parallel. [less ▲]

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See detailSurgical Management of Left Atrial Myxoma
RADERMECKER, Marc ULg; LAVIGNE, Jean-Paul ULg; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1991), 91(1), 27-31

Although rare, left atrial myxoma is an entity from anatomopathological and clinical aspects. Seven cases of left atrial myxoma operated on the last ten years were reviewed. We also report a rare ... [more ▼]

Although rare, left atrial myxoma is an entity from anatomopathological and clinical aspects. Seven cases of left atrial myxoma operated on the last ten years were reviewed. We also report a rare presentation of right atrial myxoma, where the tumor was responsible of a dramatic hemodynamic shock due to right ventricular inflow obstruction. Six patients were female, with a mean age of 53 years. All but one consulted for exertional dyspnea of recent onset. Two patients with left atrial myxoma and the patient with right atrial myxoma had experienced embolism. Five patients had systemic symptoms. Echocardiography was the most performant diagnostic procedure. All but the patient with right atrial myxoma were operated by the left atrial access. The mitral valve was replaced in two patients. The histological aspect of this benign tumor is illustrated but the lack of frank border between the tumor and the myocardium is emphasized. We conclude that surgical management is primordial. We give anatomopathological rationale for resection of implantation pedicle. The operative mortality was nul in this series of 8 patients; major improvement of cardiac status was constant. No recurrence has occurred during the follow-up period. [less ▲]

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See detailTruncal Vagotomy and Pyloroplasty Combined with Valvular Replacement in Patients with Ulcer Disease
Defraigne, Jean-Olivier ULg; Innocenti, C.; DEKOSTER, Guy ULg et al

in Journal of Cardiovascular Surgery (The) (1991), 32(1), 42-5

In 1988, 5 patients (3 men and 2 women) with ulcer disease (mean age 56 +/- 8 years) underwent valvular replacement for aortic (No. = 4) or mitral disease (No. = 1). All patients had had gastroduodenal ... [more ▼]

In 1988, 5 patients (3 men and 2 women) with ulcer disease (mean age 56 +/- 8 years) underwent valvular replacement for aortic (No. = 4) or mitral disease (No. = 1). All patients had had gastroduodenal ulcers. Preoperative gastroscopy demonstrated active ulcers (No. = 4) and a healed pyloric ulcer with pyloric stenosis (No. = 1). Despite the presence of ulcers, a non-biologic prosthesis was preferred in each patient because of their young age (No. = 3), chronic atrial fibrillation requiring anticoagulant therapy (No. = 1), and refusal of the eventuality of subsequent reoperation (No. = 1). In each patient, a truncal vagotomy with pyloroplasty was performed simultaneously with the valvular procedures by the same incision. The postoperative courses were uneventful. With a mean follow-up of 15 +/- 3 months, no gastrointestinal bleeding was observed during anticoagulant therapy. With anticoagulant drugs, bleeding may occur with a frequency of 4% per patient treatment-year, half of which are gastrointestinal in origin. Nevertheless, in selected patients with gastroduodenal ulcers, performing a vagotomy-pyloroplasty simultaneously with valvular replacement allows implantation of a non-biologic prosthesis, with greater durability than bioprosthesis. [less ▲]

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See detailCardiac Transplantation in Patients Older Than 55 Years
Defraigne, Jean-Olivier ULg; Demoulin, J.C.; VAN DAMME, Hendrik ULg et al

in Acta Chirurgica Belgica (1991), 91(1), 38-42

From 1985 to 1990, 27 patients older than 55 years (extremes 55-65 years; 21 men and 6 women) received a cardiac transplant. The cause of cardiopathy was ischemic in 70%. Postoperative immunosuppressive ... [more ▼]

From 1985 to 1990, 27 patients older than 55 years (extremes 55-65 years; 21 men and 6 women) received a cardiac transplant. The cause of cardiopathy was ischemic in 70%. Postoperative immunosuppressive therapy consisted of Cyclosporin A, steroids, azathioprine and antilymphocytic serum. Rejection episodes were monitored by endomyocardial biopsies and treated by pulses of steroids or monoclonal antibodies (OKT3). The operative mortality is 7.4% (n = 2). The one and two year survivals are 71% and 62% respectively. The incidence of infection and/or rejection were 0.71 +/- 0.4 and 1.4 +/- 0.7 episodes/patient year. Age beyond 55 years does not contraindicate heart transplantation. This change in recipient selection policy should lead to parallel changes in donor selection criteria. [less ▲]

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