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This article describes four years' experience with heart transplantation using conventional immunosuppression. Twenty of 32 patients are alive. The one-year survival rates were 75% (1979), 67% (1980), and 75% (1981). Actuarial survival rates for operative survivors were 70% at one year, 60% at two years, and 51% at three years. Patients in the 50- to 55-year age group have survived as well as younger recipients. Rejection resulted in six deaths, infection in three, donor heart failure in two, and multiple organ failure in one. There were 1.5 acute rejections per patient and one infection per patient in the first three posttransplant months. Postoperative hospital stay averaged 62 days and cost a total of $58,351.

Minocycline hydrochloride was used to treat pulmonary infections with Nocardia asteroides in five cardiac allograft recipients. In three patients, minocycline was successfully used as the only antinocardial agent. Two other patients were found to have leukopenia after initial therapy with sulfisoxazole. These two patients were subsequently treated with minocycline. The clinical success with minocycline in these highly immunosuppressed patients suggests that minocycline is an effective antinocardial agent. These data did not allow any conclusion regarding which drug, minocycline or sulfisoxazole, is superior in the treatment of this disease.