Clinical aspects of heart transplantation (original) (raw)
Related papers
Heart transplantation in the Netherlands: quo vadis?
Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2006
Heart transplantation is limited by the lack of donor organs. Twenty years after the start of the Dutch transplant programmes in Rotterdam and Utrecht the situation has even worsened, despite efforts to increase the donor pool. The Dutch situation seems to be worse than in other surrounding countries, and several factors that may influence donor organ availability and organ utilisation are discussed. The indications and contraindications for heart transplantation are presented, which are rather restrictive in order to select optimal recipients for the scarce donor hearts. Detailed data on donor hearts, rejected for transplantation, are shown to give some insight into the difficult process of dealing with marginal donor organs. It is concluded that with the current low numbers of acceptable quality donor hearts, there is no lack of capacity in the two transplanting centres nor is the waiting list limiting the number of transplants. The influence of our current legal system on organ d...
Cardiac Transplant -A Single Centre Retrospective Observation
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH
Background and Aim: Advances in pharmacological and nonpharmacological management of heart failure shifted the paradigm to transplantation of heart. Currently so many centers are doing heart transplant as the availability of donors and recipients are increasing day by day. The goal of this study is to share our experience in all our heart transplantation procedures. Ours is a tertiary care government multi super Speciality hospital. In our institute we have been doing cardiac surgeries for six years and heart transplants for past three years. In this discussion we share our experience about how we did all the procedures in our center . Method: After getting approval from institutional research committee we analyzed 8 transplants done in our center. The preoperative optimization, monitoring tools, anesthetic technique and post-operative complications and management are discussed . Apart from routine monitors we have used BIS, Cerebral oximetry and cardiac output monitors. Result: Of ...
Heart transplantation in Vienna: 25 years of experience
Wiener klinische Wochenschrift, 2008
Since the beginning of the University of Vienna Cardiac Transplant Program in 1984, 1113 heart transplant procedures have been performed through August of 2008. One-and five-year survival has increased steadily over time (82% and 76%). Ten-year survival is 65%. Over the past 25 years our program has seen dramatic changes in patient selection, accepting now patients with more risk factors (e.g. age, diabetes, elevated pulmonary resistance). Developments in immunosuppression have decreased incidence of infection, rejection and graftarteriosclerosis continuously. Our program continues to pursue novel strategies to improve the survival and quality of life of our heart transplant patients.
Our Experience in Cardiac Transplantation in Baskent University
Transplantation Proceedings, 2006
Recently cardiac transplantation has an important place in treatment of end-stage cardiac failure. In Turkey between 2003 and 2005 at 10 centers 64 cardiac transplantations were performed including five at our facility. Herein we have presented our results. All patients were men of mean age 34.2 Ϯ 10.7 (17 to 44) years. Upon preoperative echocardiography their mean ejection fraction was 18% Ϯ 3.27% (17% to 23%). Pulmonary vascular resistance was 4.47 wood unit in one patient and in one case, there was Rh incompatibility between donor and recipient. We used HTK solution for protection of donor hearts. Mean ischemia time was 251.2 Ϯ 62.7 minutes (155 to 314). Mean aortic clamping time was 84 Ϯ 4.7 minutes (80 to 90). In all patients we performed a biatrial anastomosis technique. Hemofiltration was used to prevent hemodilution during operation. In the postoperative period four patients had acute renal dysfunction; one, a minor cerebrovascular accident; two, reoperated because of bleeding; one, cholestasis; one, temporary atrio-ventricular block; and one, mediastinitis. Mean follow-up time was 15.6 Ϯ 19.7 months (2 to 50). Neither early nor late mortality has occurred. All patients are in New York Heart Association class I. In all cases we used triple immunosuppressive therapy. In the follow-up period the mean number of cardiac biopsies per patient was 4.2 Ϯ 3.03 (2 to 8). Two cases had cardiac catheterization. As a complication of cardiac biopsy, pericardial tamponade developed in one patient; in another one we observed a right ventricular aneursym after cardiac biopsy. Cardiac transplantation was performed with low mortality and morbidity rates in end-stage cardiac failure patients with longer life expectancy and higher life quality. Unfortunately in our country, because of difficulties to find donor hearts, cardiac transplantations were small in number. For better results, we need a larger series.
HEART TRANSPLANT: INDICATIONS AND PATIENTS’ QUALITY OF LIFE (Atena Editora)
HEART TRANSPLANT: INDICATIONS AND PATIENTS’ QUALITY OF LIFE (Atena Editora), 2023
Heart failure has been increasing more and more in recent years due to the population's increased longevity, advances in the treatment of acute heart attacks with the use of thrombolytics and angioplasty, the expansion of cardiac interventions and improvements in the diagnosis of the syndrome. With the current modifications incorporated into pharmacological treatment, there has been an improvement in patient survival. Therefore, the evolution of cardiomyopathy to terminal forms is unquestionable due to the characteristics of the disease and, in these situations, transplantation may be the only alternative. Heart transplantation is the only effective way to restore the patient's hemodynamic functions, however it has different limitations and does not apply to all candidates. The limitation of viable organs is one of the biggest factors that impede the development of transplants. This problem becomes more evident when it comes to organs that are more sensitive to shock and ischemia injuries. Despite the great advances made in legislation on organ transplants, there is still a lack of an effective health policy aimed at promoting the recruitment and adequate maintenance of donors so that this situation can be reversed. The quality of donated organs and the serious clinical condition of candidates arriving at transplant centers are the main factors responsible for unsatisfactory results in the immediate phase of heart transplantation. The present study aims to present a review of the indications for heart transplantation and the quality of life of patients.
Transplantação cardíaca: cinco anos de actividade
Rev Port …, 2010
A transplantação cardíaca é hoje reconhecida como uma modalidade terapêutica da insuficiência cardíaca avançada. A primeira transplantação de coração foi realizada em Cape Town, África do Sul, por Christiaan Barnard, em 3 de Dezembro de 1967. (1) Esta intervenção histórica foi seguida de muitas
Einstein (São Paulo), 2015
Heart transplantation is currently the definitive gold standard surgical approach in the treatment of refractory heart failure. However, the shortage of donors limits the achievement of a greater number of heart transplants, in which the use of mechanical circulatory support devices is increasing. With well-established indications and contraindications, as well as diagnosis and treatment of rejection through defined protocols of immunosuppression, the outcomes of heart transplantation are very favorable. Among early complications that can impact survival are primary graft failure, right ventricular dysfunction, rejection, and infections, whereas late complications include cardiac allograft vasculopathy and neoplasms. Despite the difficulties for heart transplantation, in particular, the shortage of donors and high mortality while on the waiting list, in Brazil, there is a great potential for both increasing effective donors and using circulatory assist devices, which can positively ...
Results of Heart Transplantation: 16 Years' Experience in a Center in Argentina
Transplantation Proceedings, 2010
Heart transplantation (HTx) is the treatment of choice for advanced heart failure refractory to other treatments. Objective. To report the outcomes of patients undergoing orthotopic HTx in a center with 16 years' experience. Methods. We retrospectively examined the outcomes from three hundred nine HTx recipients between February 1993 and March 2009. The mean recipient age was 46 Ϯ 16 years, and 80% were male. Ischemic cardiomyopathy was present in 37%; 43% (n ϭ 133) were elective procedures and 57% (n ϭ 176) were urgent/emergency procedures. The mean donor age was 26 years; their main cause of death was head/brain trauma. Survival was studied using Kaplan-Meier curves.