Cardiac Transplantation Beyond 55 Years of Age

Between January 1985 and December 1988, 20 patients over the age of 55 years (extremes 56-63 years; 15 men and 5 women) underwent cardiac transplantation. The cause of cardiopathy was ischemic in 70% of the cases. The immunosuppressive regimen consisted of cyclosporin A, corticoids, and azathioprine. Rejection episodes were monitored by endomyocardial biopsies and treated by pulses of corticoids or monoclonal antibodies (OKT3). The operative mortality was 10% (n = 2). The 1-year survival rate was 70%. The 1-year incidence of infection and/or rejection episodes was 1 and 1.53 episodes/patient, respectively. One patient was successfully retransplanted after 9 months because of intractable rejection. Age beyond 55 years is no longer a contraindication to cardiac transplantation. This change in recipient selection policy should lead to parallel changes in donor selection criteria

Induction of cell–cell channel formation by mRNA

Intercellular junctional communication is very common in normal organized tissue. It provides a pathway for transmission of electrical signals, especially in heart muscle, and may be important in differentiation and growth control. The hydrophilic channels which enable cell--cell communication have been well characterized by biophysical methods, and there is now good evidence that they are contained in the nexus (gap junctions). Little, however, is known about the molecular mechanism of biosynthesis of junctional channels. Knowledge in this area has been obtained almost exclusively from experiments with reaggregated cells, a system complicated by the fact that de novo synthesis of channel proteins is obscured by reassembly of pre-existing subunits or utilization of precirsors. To avoid these problems, we have now isolated mRNA from cells that are in the process of making new intercellular nexus with high efficiency, incorporated it via liposomes into communication-defective cells and have shown that the recipient cells established junctional communication