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Early experience with human heart transplantation demonstrated high vulnerability to relentless rejection and poor survival despite immunosuppression with azathioprine, steroids, and antilymphocytic globulin.
The human heart is highly vulnerable to rejection. In 16 patients with 17 allografts rejection progressed relentlessly in histocompatibility matches of C and D grades. Only three patients were still living, 63 to 181 days after transplantation, at the time of this report. The longest survival was 203 days. Signs of rejection were an increase in congestive heart failure, pericardial friction rub, electrocardiographic changes, malaise and a rise in the serum lactate dehydrogenase-1 level. Immunosuppression with azathioprine, adrenal steroids and antilymphocytic globulin has not been as successful in combating rejection over the long term as earlier experience indicated.
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Nora et al. (1969) studied this question.
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