The National Heart Hospital Surgical Lecture Transplantation of the heart

The clinical programme in heart transplantation at Stanford was launched in concept almost 20 years ago when Drs Shumway and Lower first achieved successful orthotopic heart transplantation in a canine model in 1958. After this milestone there ensued nearly a decade of orderly laboratory experience during which several important objectives that should precede the initiation of a clinical programme were accomplished. These included refinement of the operative technique to the point of routine technical success, characterization of acute cardiac allograft rejection in terms of morphology and pathophysiology and, most importantly, achievement of long-term survival with appropriate immunosuppression.