{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T13:43:35Z","timestamp":1758462215836,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1998,11,3]]},"published-print":{"date-parts":[[1999,8,1]]},"abstract":"<jats:p>A 49 year old man developed intractable heart failure three years after undergoing heart transplantation. Coronary angiography showed no evidence of graft vascular disease. An initial cardiac biopsy identified one episode of rejection which responded to augmented immunosuppressive treatment. The patient became inotrope dependent and has now survived at home for 22 months using an ambulatory delivery system for intravenous adrenaline (epinephrine), without significant complications. There has been a noticeable improvement in symptoms and left ventricular systolic performance, both clinically and as seen through echocardiographic and radiographic examination. This improvement was substantiated by the results of cardiac catheterisation, which showed a return to normal left ventricular filling pressure and cardiac output. The case is noteworthy because this treatment has allowed a patient who otherwise would have been hospital bound to return\u2009to the community. With the current shortage of organs, he would have been unlikely to receive a second transplant. The clinical features and outcome, and social, medicolegal, and financial issues are discussed.<\/jats:p>","DOI":"10.1136\/hrt.82.2.248","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"248-251","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Home inotrope treatment for intractable heart failure following heart transplantation"],"prefix":"10.1136","volume":"82","author":[{"given":"S W","family":"Dubrey","sequence":"first","affiliation":[{"name":"Transplant Clinic, Harefield Hospital, Royal Brompton and Harefield NHS Trust, Harefield, Middlesex UB9 6JH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Banner","sequence":"additional","affiliation":[{"name":"Transplant Clinic, Harefield Hospital, Royal Brompton and Harefield NHS Trust, Harefield, Middlesex UB9 6JH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1999,8,1]]},"reference":[{"key":"2025092100365726000_82.2.248.1","first-page":"656","article-title":"The Registry for the International Society for Heart and Lung Transplantation: fifteenth official report.","volume":"17","author":"Hosenpud","year":"1998","journal-title":"J Heart Lung Transplant"},{"doi-asserted-by":"publisher","key":"2025092100365726000_82.2.248.2","DOI":"10.1016\/S0002-9149(83)80079-4"},{"doi-asserted-by":"publisher","key":"2025092100365726000_82.2.248.3","DOI":"10.1097\/00003246-199001002-00005"},{"key":"2025092100365726000_82.2.248.4","first-page":"482","article-title":"Outpatient dobutamine for refractory congestive heart failure: advantages, techniques and results.","volume":"10","author":"Miller","year":"1991","journal-title":"J Heart Lung Transplant"},{"key":"2025092100365726000_82.2.248.5","first-page":"S126","article-title":"Out patient use of dobutamine to support patients awaiting heart transplantation.","volume":"13","author":"Miller","year":"1993","journal-title":"J Heart Lung Transplant"},{"key":"2025092100365726000_82.2.248.6","first-page":"37","article-title":"Intermittent dobutamine in ambulatory patients with chronic cardiac failure.","volume":"40 (suppl)","author":"Dies","year":"1986","journal-title":"Br J Clin Pract"},{"doi-asserted-by":"publisher","key":"2025092100365726000_82.2.248.7","DOI":"10.1378\/chest.112.5.1298"},{"doi-asserted-by":"publisher","key":"2025092100365726000_82.2.248.8","DOI":"10.1161\/01.CIR.79.2.344"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.82.2.248","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T07:37:03Z","timestamp":1758440223000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.82.2.248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,8,1]]},"references-count":8,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1999,8,1]]},"published-print":{"date-parts":[[1999,8,1]]}},"alternative-id":["10.1136\/hrt.82.2.248"],"URL":"https:\/\/doi.org\/10.1136\/hrt.82.2.248","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"type":"print","value":"1355-6037"},{"type":"electronic","value":"1468-201X"}],"subject":[],"published":{"date-parts":[[1999,8,1]]}}}