Successful recycling of a previously transplanted heart: another option for limited resources.

We report a case of successful reuse of a previously transplanted heart. The organ was retransplanted 16 days after the initial transplantation into a 60-year-old man who had previously received a left ventricular assist device.

A randomized controlled trial of daclizumab versus anti-thymocyte globulin induction for heart transplantation.

BACKGROUND: The purpose of this study was to test the efficacy and safety of daclizumab (DZM) versus anti-thymocyte globulin (ATG) as a component of induction therapy in heart transplant recipients. METHODS: Thirty heart transplant patients were randomized to receive either ATG or DZM during induction therapy. Patients in the DZM group received an initial dose of 2 mg/kg intravenous (IV) at the time of transplant and 1 mg/kg IV on postoperative day 4. DISCUSSION: Recipient, donor, and intraoperative variables did not differ significantly between groups. The cost of induction therapy, total drug cost, and hospital ward costs were significantly less for the DZM group. Average absolute lymphocyte and platelet counts were significantly higher in the DZM group. There were no significant differences in the incidence of rejection, infection, malignancy, or steroid-induced diabetes. One year survival was excellent in both groups (87%, P = 0.1). Daclizumab is a safe component of induction therapy in heart transplantation.

Massive left atrial sarcoma presenting with severe congestive heart failure.

Primary intimal sarcomas of the left atrium are extremely rare and highly aggressive tumours. To our knowledge, only 4 cases have been reported to date. We report on a 42-year-old man who presented with signs of congestive heart failure and was found to have an enormous left atrial bilobed tumour with obstruction of the mitral valve. The patient underwent a surgical excision of the sarcoma. The tumour recurred 8.5 months later and the patient required right pneumonectomy.