Heart transplantation

2019 ◽  
pp. 165-182
Author(s):  
Finn Gustafsson ◽  
Kasper Rossing
Keyword(s):  
Heart Transplantation ◽  
Conventional Treatment ◽  
Immunosuppressive Drugs ◽  
Pharmacological Therapy ◽  
Cardiac Allograft ◽  
Term Outcome ◽  
Long Term Outcome ◽  
End Stage Heart Failure ◽  
End Stage

Heart transplantation remains the treatment of choice for end-stage heart failure refractory to conventional treatment. Long-term outcome is excellent, and median survival currently exceeds 13 years. The main causes of death late after transplantation are cardiac allograft vasculopathy and cancer. Medical therapy after transplantation is complex, including immunosuppressive therapy to reduce the risk of graft rejection and prophylaxis against viral and protozoal infections, as well as adjunctive therapy to treat common comorbidities, for instance hypertension. Pharmacological therapy of comorbid conditions requires specific consideration to clinically important interactions with immunosuppressive drugs.

Heart transplantation

2019 ◽  
pp. 165-182
Author(s):  
Finn Gustafsson ◽  
Kasper Rossing
Keyword(s):  
Heart Transplantation ◽  
Conventional Treatment ◽  
Immunosuppressive Drugs ◽  
Pharmacological Therapy ◽  
Cardiac Allograft ◽  
Term Outcome ◽  
Long Term Outcome ◽  
End Stage Heart Failure ◽  
End Stage

Heart transplantation remains the treatment of choice for end-stage heart failure refractory to conventional treatment. Long-term outcome is excellent, and median survival currently exceeds 13 years. The main causes of death late after transplantation are cardiac allograft vasculopathy and cancer. Medical therapy after transplantation is complex, including immunosuppressive therapy to reduce the risk of graft rejection and prophylaxis against viral and protozoal infections, as well as adjunctive therapy to treat common comorbidities, for instance hypertension. Pharmacological therapy of comorbid conditions requires specific consideration to clinically important interactions with immunosuppressive drugs.

scholarly journals Determinants of Elevated D-Dimer Levels and Long-Term Outcome in Elderly Patients With End-Stage Heart Failure

2021 ◽  
Author(s):  
Aiju Tian ◽  
Chengzhi Yang ◽  
Shengfeng Weng ◽  
Xiaoli Chen ◽  
Hong Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
Functional Class ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cell Counts ◽  
End Stage Heart Failure ◽  
End Stage ◽  
D Dimer

Abstract Background Previous studies have shown that heart failure is associated with hemostatic abnormalities and hypercoagulable state. Plasma D-dimer levels reflect both fibrin formation and degradation, and elevated D-dimer levels have been associated with poor prognosis in patients with heart failure. However, little is known about their roles in elderly patients with end-stage HF. In present study, we aimed to explore the clinical significance and determinants of plasma D-dimer in elderly patients with end-stage heart failure. Methods A total of 177 patients with heart failure at Beijing Geriatric Hospital from November 1, 2015 to December 30, 2018 were enrolled. All hospitalized patients were obtained D-dimer levels within the first 24 h following admission after obtaining informed consent. Primary endpoint was all-cause mortality. Results A total of 60 patients had elevated D-dimer levels. Blood urea nitrogen (β = 1.106, 95% CI: 1.029–1.190, p = 0.006), NYHA functional class (β = 2.179, 95% CI: 1.170–4.056, p = 0.014) and white blood cell counts (β = 1.188, 95% CI: 1.040–1.358, p = 0.011) were independent risk factors for elevated D-dimer in elderly patients with end-stage heart failure. Albumin (β = 0.803, 95% CI: 0.728–0.885, P ༜ 0.001) was negative risk factor for elevated D-dimer in elderly patients with end-stage heart failure. Elevated D-dimer level was independently associated with increased risk of long-term all-cause mortality (P = 0.048). Conclusions For elderly patients with end-stage heart failure, D-dimer levels were associated with white blood cell counts, blood urea nitrogen, albumin and NYHA functional class and elevated D-dimer level was independently associated with poor long-term outcome.

Orthotopic Heart Transplantation through Minimally Invasive Approach

2007 ◽  
Vol 15 (5) ◽  
pp. 446-448 ◽  
Author(s):  
Jose L Navia ◽  
Eric E Roselli ◽  
Fernando A Atik ◽  
Gonzalo V Gonzalez-Stawinski ◽  
Nicholas G Smedira
Keyword(s):  
Minimally Invasive ◽  
Heart Transplantation ◽  
Orthotopic Heart Transplantation ◽  
Cardiac Transplant ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Invasive Approach ◽  
End Stage ◽  
Invasive Techniques

Minimal access approaches are a trend in cardiothoracic surgery. Gained experience in these minimally invasive techniques have allowed its application to more complicated procedures, such as heart transplantation. Both classic and bicaval techniques of cardiac transplant were performed through a partial lower sternotomy in 10 end-stage heart failure patients with no previous cardiac surgery. The procedure was considered safe with adequate exposure, minimal postoperative pain medication requirements, acceptable operative times, and good long-term outcome.

scholarly journals Determinants of Elevated D-dimer Levels and Long-Term Outcome in Elderly Patients with End-Stage Heart Failure

2021 ◽  
Author(s):  
Aiju Tian ◽  
Chengzhi Yang ◽  
Shengfeng Weng ◽  
Xiaoli Chen ◽  
Hong Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
Functional Class ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cell Counts ◽  
End Stage Heart Failure ◽  
End Stage ◽  
D Dimer

Abstract Background: Previous studies have shown that heart failure is associated with hemostatic abnormalities and hypercoagulable state. Plasma D-dimer levels reflect both fibrin formation and degradation, and elevated D-dimer levels have been associated with poor prognosis in patients with heart failure. However, little is known about their roles in elderly patients with end-stage HF. In present study, we aimed to explore the clinical significance and determinants of plasma D-dimer in elderly patients with end-stage heart failure. Methods: A total of 177 patients with heart failure at Beijing Geriatric Hospital from November 1, 2015 to December 30, 2018 were enrolled. All hospitalized patients were obtained D-dimer levels within the first 24 h following admission after obtaining informed consent. Primary endpoint was all-cause mortality. Results: A total of 60 patients had elevated D-dimer levels. Blood urea nitrogen (β=1.106, 95% CI: 1.029-1.190, p = 0.006), NYHA functional class (β=2.179, 95% CI: 1.170-4.056, p = 0.014) and white blood cell counts (β = 1.188, 95% CI: 1.040-1.358, p = 0.011) were independent risk factors for elevated D-dimer in elderly patients with end-stage heart failure. Albumin (β=0.803, 95% CI: 0.728-0.885, P ＜ 0.001) was negative risk factor for elevated D-dimer in elderly patients with end-stage heart failure. Elevated D-dimer level was independently associated with increased risk of long-term all-cause mortality (P = 0.048). Conclusions: For elderly patients with end-stage heart failure, D-dimer levels were associated with white blood cell counts, blood urea nitrogen, albumin and NYHA functional class and elevated D-dimer level was independently associated with poor long-term outcome.

Long term outcome after heterotopic heart transplantation

2011 ◽  
Vol 59 (S 01) ◽  
Author(s):  
J Sindermann ◽  
I Alejnik ◽  
J Hoffmann ◽  
S Klotz ◽  
A Löher ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Heterotopic Heart Transplantation

Biopsy-Negative Rejection Late after Heart Transplantation: Impact on Long-Term Outcome

2019 ◽  
Vol 38 (4) ◽  
pp. S287-S288
Author(s):  
A. Wolfson ◽  
M. Kittleson ◽  
J. Patel ◽  
E. Kransdorf ◽  
R. Cole ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Complications and outcome of the long-term use of the intra-aortic balloon pump in patients with end-stage heart failure

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Stratinaki ◽  
E Bousoula ◽  
I Malakos ◽  
M Zymatoura ◽  
E Fountas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pharmacological Therapy ◽  
Circulatory Support ◽  
Intra Aortic Balloon Pump ◽  
Funding Sources ◽  
Iabp Support ◽  
End Stage Heart Failure ◽  
The Mean ◽  
End Stage

Abstract Funding Acknowledgements Type of funding sources: None. Background Intra-aortic balloon pump (IABP) can be used as circulatory support in order to stabilize haemodynamically compromised patients as either a bridge to therapy or to further mechanical support. Based on the current literature its use should be limited to up to two weeks and there are not enough data regarding its long term use’s efficacy and possible complications. Purpose To review the possible complications of the long-term use of IABP Methods We restrospectively analysed the data from 24 consecutive patients with end-stage heart failure (ESHF) who received long-term IABP support and recorded the complications during their hospitalization as well as their outcome. Results 24 patients (14 male and 10 female) were included. In 5 of them ESHF was attributed to ischemic cardiomyopathy and the in 19 to dilated cardiomyopathy. Their mean age was 45.6+/-14 years. The mean duration of IABP support was 70.2 days (minimum 30days maximum 192 days). The mean ejection fraction (EF) was 20%. Regarding the pharmacological therapy, 12/24 patients were on dobutamine, 4/24 on dobutamine and milrinone and 8/24 on dobutamine and noradrenaline. Regarding the clinical course of these patients, 7/24 underwent heart transplantation, 2/24 managed to wean from IABP, 5/24 received left lentrivular assist device (LVAD), 6/24 received biventricular assist veice (BiVAD) and 4/24 died. In terms of complications they were recorded as following : infection 7/24, bleeding 3/24, thrombosis 4/24, heparin-induced thrombocytopenia(HIT) 5/24, hematoma 4/24, ischemia 0/24 and rupture 1/24. Conclusions   Although not indicated by the current guidelines, long term IABP can be used as a relatively safe  circulatory support method.

251 BYPASSED DONOR HEARTS: THE LONG TERM OUTCOME AFTER HEART TRANSPLANTATION

2005 ◽  
Vol 53 (1) ◽  
pp. S121.5-S122
Author(s):  
N. P. Almeda ◽  
J. Odim ◽  
H. Laks ◽  
J. K. Patel ◽  
M. Hamilton ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Term Outcome ◽  
Long Term Outcome
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