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Development of natural gas resources in the United States has increased dramatically over the past two decades, a boom driven by favorable prices, new technological developments, and growing interest in domestic sources of energy with a smaller carbon footprint than coal or oil. Most of the expansion in U.S. natural gas production has been from so-called ‘unconventional’ reserves in which extensive natural gas resources trapped in continuous sandstone and shale formations can now be extracted using modern directional drilling and hydraulic fracturing technologies. The Uintah Basin in northeastern Utah has been one of several areas in the U.S. where major tight sands and shale gas plays have been the focus of recent natural gas exploration and development.

Since July 1982, 18 patients have undergone orthotopic cardiac transplantation at the Texas Heart Institute with steroid and cyclosporine immunosuppression. There have been no deaths from infection despite 15 bacterial, 8 viral, 6 fungal and 1 protozoal infection episodes. With a total follow-up of 90 patient months (mean follow-up, 5.0 months; range 0.1 to 18 months), the incidence of infection is 33 episodes per 100 patient months (1.7 episodes per patient). Only 23 episodes (77%) required drug treatment. Compared to conventional immunosuppressive regimes, cyclosporine treatment is associated with a substantial reduction in the incidence and severity of infection in cardiac allograft recipients.