Skip to main content
SpringerLink
Log in

Postoperative Care of the Heart Transplant Patient

  • Chapter
Book cover Surgical Intensive Care Medicine

Abstract

Heart transplantation has become established as a highly successful therapy for patients with advanced cardiac failure (1). Survival rates after transplantation far exceed those achieved by medical therapy for this condition (2). Transplantation is a complex process that requires careful integration of pre- and postoperative care. Transplant activity is now limited by the supply of donor organs, leading to increased waiting times before surgery and necessitating careful selection of candidates for transplantation (1,3).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Banner N. Heart transplantation and the current management of advanced heart failure. In: Pusey C, ed. Horizons in Medicine. London: Royal College of Physicians of London. 1999: 359–71.

    Google Scholar 

  2. Hosenpud JD, Bennett LE, Keck BM, Fiol B, Boucek MM, Novick RJ. The Registry of the International Society for Heart and Lung Transplantation: fifteenth official report-1998. J Heart Lung Transplant 1998; 17: 656–68.

    PubMed  CAS  Google Scholar 

  3. Anguita M, Arizon JM, Valles F, Montero JA, Sancho M, Bueno G, Latre JM, Lopez-Rubio F, Concha M. Influence on survival after heart transplantation of contraindications seen in transplant recipients. J Heart Lung Transplant 1992; 11: 708–15.

    PubMed  CAS  Google Scholar 

  4. Ho KK, Anderson KM, Kannel WB, Grossman W, Levy D. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation 1993; 88: 107–15.

    Article  PubMed  CAS  Google Scholar 

  5. Gheorghiade M, Cody RJ, Francis GS, McKenna WJ, Young JB, Bonow RO. Current medical therapy for advanced heart failure. Am Heart J 1998; 135: S231–48.

    Article  PubMed  CAS  Google Scholar 

  6. Marwick TH. The viable myocardium: epidemiology, detection, and clinical implications. Lancet 1998; 351: 815–9.

    Article  PubMed  CAS  Google Scholar 

  7. Mancini DM, Eisen H, Kussmaul W, Mull R, Edmunds LH, Jr., Wilson JR. Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure. Circulation 1991; 83: 778–86.

    Article  PubMed  CAS  Google Scholar 

  8. Aaronson KD, Schwartz S, Chen TM, Wong KL, Goin JE, Mancini DM. Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. Circulation 1997; 95: 2660–7.

    Article  PubMed  CAS  Google Scholar 

  9. Mudge GH, Goldstein S, Addonizio LJ, Caplan A, Mancini D, Levine TB, Ritsch ME Jr, Stevenson LW. 24th Bethesda conference: Cardiac transplantation. Task Force 3: Recipient guidelines/prioritization. J Am Coll Cardiol 1993; 22: 21–31.

    Article  PubMed  CAS  Google Scholar 

  10. Costanzo MR, Augustine S, Bourge R, Bristow M, O’Connell JB, Driscoll D, Rose E. Selection and treatment of candidates for heart transplantation. A statement for health professionals from the Committee on Heart Failure and Cardiac Transplantation of the Council on Clinical Cardiology, American Heart Association. Circulation 1995; 92: 3593–612.

    Google Scholar 

  11. Weed LL. Medical records that guide and teach. N Engl J Med 1968; 278: 593–600.

    Article  PubMed  CAS  Google Scholar 

  12. Kantrowitz A, Tjonneland S, Krakauer JS, Phillips SJ, Freed PS, Butner AN. Mechanical intraaortic cardiac assistance in cardiogenic shock. Hemodynamic effects. Arch Surg I968; 97: 1000–4.

    Google Scholar 

  13. Goldberg MJ, Rubenfire M, Kantrowitz A, Goodman G, Freed PS, Hallen L, Reimann P. Intraaortic balloon pump insertion: a randomized study comparing percutaneous and surgical techniques. J Am Coll Cardiol 1987; 9: 515–23.

    Article  PubMed  CAS  Google Scholar 

  14. Torchiana DF, Hirsch G, Buckley MJ, Hahn C, Allyn JW, Akins CW, Drake JF, Newell JB, Austen WG. Intraaortic balloon pumping for cardiac support: trends in practice and outcome, 1968 to 1995. J Thorac Cardiovasc Surg 1997;113:758–64; discussion 764–9.

    Google Scholar 

  15. Rodigas PC, Finnegan JO. Technique for removal of percutaneously placed intraaortic balloons. Ann Thorac Surg 1985; 40: 80–1.

    Article  PubMed  CAS  Google Scholar 

  16. Funk M, Gleason J, Foell D. Lower limb ischemia related to use of the intraaortic balloon pump. Heart Lung 1989; 18: 542–52.

    PubMed  CAS  Google Scholar 

  17. Alle KM, White GH, Harris JP, May J, Baird D. Iatrogenic vascular trauma associated with intraaortic balloon pumping: identification of risk factors. Am Surg 1993; 59: 813–7.

    PubMed  CAS  Google Scholar 

  18. Champsaur G, Ninet J, Vigneron M, Cochet P, Neidecker J, Boissonnat P. Use of the Abiomed BVS System 5000 as a bridge to cardiac transplantation. J Thorac Cardiovasc Surg 1990; 100: 122–8.

    PubMed  CAS  Google Scholar 

  19. Farrar DJ, Hill JD. Univentricular and biventricular Thoratec VAD support as a bridge to transplantation. Ann Thorac Surg 1993; 55: 276–82.

    Article  PubMed  CAS  Google Scholar 

  20. McCarthy PM, Sabik JF. Implantable circulatory support devices as a bridge to heart transplantation. Semin Thorac Cardiovasc Surg 1994; 6: 174–80.

    PubMed  CAS  Google Scholar 

  21. Portlier PM, Oyer PE, Pennington DG, Baumgartner WA, Griffith BP, Frist WR, Magilligan DJ Jr, Noon GP, Ramasamy N, Miller PJ, Jassawalla JS. Implantable electrical left ventricular assist system: bridge to transplantation and the future. Ann Thorac Surg 1989; 47: 142–50.

    Article  Google Scholar 

  22. Oz MC, Argenziano M, Catanese KA, Gardocki MT, Goldstein DJ, Ashton RC, Gelijns AC, Rose EA, Levin HR. Bridge experience with long-term implantable left ventricular assist devices. Are they an alternative to transplantation? Circulation 1997; 95: 1844–52.

    Article  PubMed  CAS  Google Scholar 

  23. Frazier OH, Rose EA, McCarthy P, Burton NA, Tector A, Levin H, Kayne HL, Poirier VL, Dasse KA. Improved mortality and rehabilitation of transplant candidates treated with a long-term implantable left ventricular assist system. Ann Surg 1995; 222: 327–36.

    Article  PubMed  CAS  Google Scholar 

  24. Oz MC, Goldstein DJ, Pepino P, Weinberg AD, Thompson SM, Catanese KA, Vargo RL, McCarthy PM, Rose EA, Levin HR. Screening scale predicts patients successfully receiving longterm implantable left ventricular assist devices. Circulation 1995;92(9 Suppl):II169–73.

    Google Scholar 

  25. Swartz MT, Votapka TV, McBride LR, Lohman DP, Moroney DA, Pennington DG. Risk stratification in patients bridged to cardiac transplantation. Ann Thorac Surg 1994; 58: 1142–5.

    Article  PubMed  CAS  Google Scholar 

  26. Oz MC, Goldstein DJ, Rose EA. Preperitoneal placement of ventricular assist devices: an illustrated stepwise approach. J Card Surg 1995; 10: 288–94.

    Article  PubMed  CAS  Google Scholar 

  27. Argenziano M, Choudhri AF, Moazami N, Rose EA, Smith CR, Levin HR, Smerling Ai, Oz MC. Randomized, double-blind trial of inhaled nitric oxide in LVAD recipients with pulmonary hypertension. Ann Thorac Surg 1998; 65: 340–5.

    Article  PubMed  CAS  Google Scholar 

  28. Goldstein DJ, Seldomridge JA, Chen JM, Catanese KA, DeRosa CM, Weinberg AD, Smith CR., Rose EA, Levin HR, Oz MC. Use of aprotinin in LVAD recipients reduces blood loss, blood use, and perioperative mortality. Ann Thorac Surg 1995; 59: 1063–7.

    Article  PubMed  CAS  Google Scholar 

  29. UNOS. Allocation of Hearts and Lungs and Heart-Lung Combinations. http://www.unos.org (June 2000).

    Google Scholar 

  30. Frazier OH, Macris MP, Myers T.1, Duncan JM, Radovancevic B, Parnis SM, Cooley DA. Improved survival after extended bridge to cardiac transplantation. Ann Thorac Surg 1994; 57: 1416–22.

    Article  PubMed  CAS  Google Scholar 

  31. Pagani FD, Lynch W, Swaniker F, Dyke DB, Bartlett R, Koelling T, Moscucci M, Deeb GM, Bolling S, MonaghanH, Aaronson KD. Extracorporeal life support to left ventricular assist device bridge to heart transplant: A strategy to optimize survival and resource utilization. Circulation 1999;100(19 Suppl):II206–10.

    Google Scholar 

  32. Smith M. Management of the multiple organ donor. Surgery 1998; 16: 180–3.

    Google Scholar 

  33. Baldwin JC, Anderson JL, Boucek MM, Bristow MR, Jennings B, Ritsch ME, Jr., Silverman NA. 24th Bethesda conference: Cardiac transplantation. Task Force 2: Donor guidelines. J Am Coll Cardiol 1993; 22: 15–20.

    Article  PubMed  CAS  Google Scholar 

  34. Wheeldon DR, Potter CD, Oduro A, Waliwork J, Large SR. Transforming the “unacceptable” donor: outcomes from the adoption of a standardized donor management technique. J Heart Lung Transplant 1995; 14: 734–42.

    PubMed  CAS  Google Scholar 

  35. Hauptman P, Mudge G. Evaluation and management of potential heart donors for transplantation. Cardiol Rev 1998; 6: 100–106.

    Article  Google Scholar 

  36. Bittner HB, Kendall SW, Chen EP, Van Trigt P. The combined effects of brain death and cardiac graft preservation on cardiopulmonary hemodynamics and function before and after subsequent heart transplantation. J Heart Lung Transplant 1996; 15: 764–77.

    PubMed  CAS  Google Scholar 

  37. Young JB, Naftel DC, Bourge RC, Kirklin JK, Clemson BS, Porter CB, Rodeheffer R.1, Kenzora JL. Matching the heart donor and heart transplant recipient. Clues for successful expansion of the donor pool: a multivariable, multiinstitutional report. The Cardiac Transplant Research Database Group. J Heart Lung Transplant 1994; 13: 353–64.

    PubMed  CAS  Google Scholar 

  38. Del Rizzo DF, Menkis AH, Pflugfelder PW, Novick RJ, McKenzie FN, Boyd WD, Kostok WJ. The role of donor age and ischemic time on survival following orthotopic heart transplantation. J Heart Lung Transplant 1999; 18 (4): 310–9.

    Article  PubMed  Google Scholar 

  39. Dietrich W, Dilthey G, Spannagl M, Richter JA. Warfarin pretreatment does not lead to increased bleeding tendency during cardiac surgery. J Cardiothorac Vase Anesth 1995; 9: 250–4.

    Article  CAS  Google Scholar 

  40. Lower RR, Shumway NE. Tissue transplantation: studies on orthotopic homotransplantation of the canine heart. Surg Forum 1960; 11: 18–19.

    PubMed  CAS  Google Scholar 

  41. Banner N, Khaghani A, Fitzgerald M, Mitchell A, Radley-Smith R, Yacoub M. The expanding role of cardiac transplantation. In: Unger F, ed. Assisted circulation 3. Berlin: Springer-Verlag; 1989: 448–67.

    Chapter  Google Scholar 

  42. Dreyfus G, Jebara V, Mihaileanu S, Carpentier AF. Total orthotopic heart transplantation: an alternative to the standard technique. Ann Thorac Surg 1991; 52: 1181–4.

    Article  PubMed  CAS  Google Scholar 

  43. Bleasdale RA, Partridge J, Banner NR. Obstruction of the inferior vena cava following total heart lung transplantation: successful treatment by balloon angioplasty. J Heart Lung Transplant 2000; 19: 488–91.

    Article  PubMed  CAS  Google Scholar 

  44. Yacoub MH, Banner NR, Khaghani A, Fitzgerald M, Madden B, Tsang V, Radley-Smith R, Hodson M. Heart-lung transplantation for cystic fibrosis and subsequent domino heart transplantation. J Heart Transplant 1990; 9: 459–66.

    PubMed  CAS  Google Scholar 

  45. Bleasdale R, Banner N, Anyanwu A, Khaghani A, Mitchell A, Yacoub MH. Medium term results of heterotopic heart transplantation (abstract). Heart 2000; 83 (Suppl 1): P35.

    Article  Google Scholar 

  46. Tagusari O, Kormos RL, Kawai A, Yamazaki K, Pham SM, Hattler BG, Murali S, Griffith BP. Native heart complications after heterotopic heart transplantation: insight into the potential risk of left ventricular assist device. J Heart Lung Transplant 1999; 18: 1111–9.

    Article  PubMed  CAS  Google Scholar 

  47. Shore-Lesserson L, Reich DL, DePerio M, Silvay G. Autologous platelet-rich plasmapheresis: risk versus benefit in repeat cardiac operations. Anesth Analg 1995; 81: 229–35.

    PubMed  CAS  Google Scholar 

  48. Mallett SV, Cox DJ. Thrombelastography. Br J Anaesth 1992; 69: 307–13.

    Article  PubMed  CAS  Google Scholar 

  49. Prendergast TW, Furukawa S, Beyer AJ, 3rd, Eisen HJ, McClurken JB, Jeevanandam V. Defining the role of aprotinin in heart transplantation. Ann Thorac Surg 1996; 62: 6704.

    Article  Google Scholar 

  50. Royston D. High-dose aprotinin therapy: a review of the first five years’ experience. J Cardiothorac Vase Anesth 1992; 6: 76–100.

    Article  CAS  Google Scholar 

  51. Propst JW, Siegel LC, Feeley TW. Effect of aprotinin on transfusion requirements during repeat stemotomy for cardiac transplantation surgery. Transplant Proc 1994; 26: 3719–21.

    PubMed  CAS  Google Scholar 

  52. Portela D, Patel R, Larson-Keller JJ, Ilstrup DM, Wiesner RH, Steers JL, Krom RA, Paya CV. OKT3 treatment for allograft rejection is a risk factor for cytomegalovirus disease in liver transplantation. J Infect Dis 1995; 171: 1014–8.

    Article  PubMed  CAS  Google Scholar 

  53. Swinnen LJ, Costanzo-Nordin MR, Fisher SG, O’Sullivan EJ, Johnson MR, Heroux AL, Dizikes GJ, Pifarre R, Fisher RI. Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiac-transplant recipients. N Engl J Med 1990; 323: 1723–8.

    Article  PubMed  CAS  Google Scholar 

  54. Opelz G, Henderson R. Incidence of non-Hodgkin lymphoma in kidney and heart transplant recipients. Lancet 1993; 342: 1514–6.

    Article  PubMed  CAS  Google Scholar 

  55. Reichart B, Meiser B, Vigano M, Rinaldi M, Martinelli L, Yacoub M, Banner NR, Gandjbakheh 1, Dorent R, Hetzer R, Hummel M. European Multicenter Tacrolimus (FK506) Heart Pilot Study: one-year results-European Tacrolimus Multicenter Heart Study Group. J Heart Lung Transplant 1998; 17: 775–81.

    PubMed  CAS  Google Scholar 

  56. Eisen HJ, Hobbs RE, Davis SF, Laufer G, Mancini DM, Renlund DG, Valantine H, Ventura H, Vachiery JL, Bourge RC, Canver CC, Carrier M, Costanzo MR, Copeland J, Dureau G, Frazier OH, Dorent R, Hauptman PJ, Kells C, Master R, Michaud JL, Paradis I, Smith A, Vanhaecke J, Feutren G, Turkin D, Mellein B, Mueller EA. Safety, tolerability and efficacy of cyclosporine microemulsion in heart transplant recipients: a randomized, multicenter, double-blind comparison with the oil based formulation of cyclosporine-results at six months after transplantation. Transplantation 1999; 68: 663–71.

    Article  PubMed  CAS  Google Scholar 

  57. Waldmann TA, O’Shea J. The use of antibodies against the IL-2 receptor in transplantation. Curr Opin Immunol 1998; 10: 507–12.

    Article  PubMed  CAS  Google Scholar 

  58. Nashan B, Moore R, Amlot P, Schmidt AG, Abeywickrama K, Soulillou JR Randomised trial of basiliximab versus placebo for control of acute cellular rejection in renal allograft recipients. CHEB 201 International Study Group Lancet 1997;350:1193–8. [erratum: Lancet 1997 Nov 15; 350: 1484 ].

    Google Scholar 

  59. Vincenti F, Kirkman R, Light S, Bumgardner G, Pescovitz M, Halloran P, Neylan J, Wilkinson A, Ekberg H, Gaston R, Backman L, Burdick J. Interleukin-2-receptor blockade with daclizumab to prevent acute rejection in renal transplantation. Daclizumab Triple Therapy Study Group. N Engl J Med 1998; 338: 161–5.

    Article  PubMed  CAS  Google Scholar 

  60. Beniaminovitz A, Itescu S, Lietz K, Donovan M, Burke EM, Groff BD, Edwards N, Mancini DM. Prevention of rejection in cardiac transplantation by blockade of the interleukin-2 receptor with a monoclonal antibody. N Engl J Med 2000; 342: 613–9.

    Article  PubMed  CAS  Google Scholar 

  61. Banner N. Immunosuppressive agents. Surgery 1998; 16: 30–3.

    Google Scholar 

  62. Taylor DO, Barr ML, Radovancevic B, Renlund DG, Mentzer RM, Jr., Smart FW, Tolman DE, Frazier OJ, Young JB, VanVeldhuisen P. A randomized, multicenter comparison of tacrolimus and cyclosporine immunosuppressive regimens in cardiac transplantation: decreased hyperlipidemia and hypertension with tacrolimus. J Heart Lung Transplant 1999; 18: 336–45.

    Article  PubMed  CAS  Google Scholar 

  63. Kahan BD. Cyclosporine. N Engl J Med 1989; 321 (25): 1725–38.

    Article  PubMed  CAS  Google Scholar 

  64. Kobashigawa J, Miller L, Renlund D, Mentzer R, Alderman E, Bourge R, Costanzo M, Eisen H, Dureau G, Ratkovec R, Hummel M, Ipe D, Johnson J, Keogh A, Mamelok R, Mancini D, Smart F, Valentine H. A randomized active-controlled trial of mycophenolate mofetil in heart transplant recipients. Mycophenolate Mofetil Investigators. Transplantation 1998; 66: 507–15.

    Article  PubMed  CAS  Google Scholar 

  65. Kobashigawa JA, Katznelson S, Laks H, Johnson JA, Yeatman L, Wang XM, Chia D, Terasaki PI, Sabad A, Cogert GA, Trosian K, Hamilton MA, Moriguchi JD, Kawata N, Hage A, Drinkwater DC, Stevenson LW. Effect of pravastatin on outcomes after cardiac transplantation. N Engl J Med 1995; 333: 621–7.

    Article  PubMed  CAS  Google Scholar 

  66. Smith JD, Danskine AJ, Laylor RM, Rose ML, Yacoub MH. The effect of panel reactive antibodies and the donor specific crossmatch on graft survival after heart and heart-lung transplantation. Transpl Immunol 1993; 1: 60–5.

    Article  PubMed  CAS  Google Scholar 

  67. Caves PK, Stinson EB, Billingham ME, Shumway NE. Serial transvenous biopsy of the transplanted human heart. Improved management of acute rejection episodes. Lancet 1974; 1: 821–6.

    Article  PubMed  CAS  Google Scholar 

  68. Miller LW, Labovitz AJ, McBride LA, Pennington DG, Kanter K. Echocardiography-guided endomyocardial biopsy. A 5-year experience. Circulation 1988; 78: 11199–102.

    Article  Google Scholar 

  69. Billingham ME, Cary NR, Hammond ME, Kemnitz J, Marboe C, McCallister HA, Snovar DC, Winters GL, Zerbe A. A.working formulation for the standardization of nomenclature in the diagnosis of heart and lung rejection: Heart Rejection Study Group. The International Society for Heart Transplantation. J Heart Transplant 1990; 9: 587–93.

    CAS  Google Scholar 

  70. Kirklin JK, Naftel DC, Kirkin JW, Blackstone EH, White-Williams C, Bourge RC. Pulmonary vascular resistance and the risk of heart transplantation. J Heart Transplant 1988; 7: 331–6.

    PubMed  CAS  Google Scholar 

  71. Costard-Jackle A, Fowler MB. Influence of preoperative pulmonary artery pressure on mortality after heart transplantation: testing of potential reversibility of pulmonary hypertension with nitroprusside is useful in defining a high risk group. J Am Coll Cardiol 1992; 19: 48–54.

    Article  PubMed  CAS  Google Scholar 

  72. Bittner HB, Chen EP, Kendall SW, Van Trigt P. Brain death alters cardiopulmonary hemodynamics and impairs right ventricular power reserve against an elevation of pulmonary vascular resistance. Chest 1997; 111: 706–11.

    Article  PubMed  CAS  Google Scholar 

  73. Kieler-Jensen N, Lundin S, Ricksten SE. Vasodilator therapy after heart transplantation: effects of inhaled nitric oxide and intravenous prostacyclin, prostaglandin El, and sodium nitroprusside. J Heart Lung Transplant 1995; 14: 436–43.

    PubMed  CAS  Google Scholar 

  74. Rajek A, Pernerstorfer T, Kastner J, Mares P, Grabenwoger M, Sessler DI, Grubhofer G, Hiesmayr M. Inhaled nitric oxide reduces pulmonary vascular resistance more than prostaglandin E(1) during heart transplantation. Anesth Analg 2000; 90: 523–30.

    Article  PubMed  CAS  Google Scholar 

  75. Cuthbertson BH, Dellinger P, Dyar OJ, Evans TE, Higenbottam T, Latimer R, Payen D, Stott SA, Webster NR, Young JD. UK guidelines for the use of inhaled nitric oxide therapy in adult ICUs. American-European Consensus Conference on ALI/ARDS. Intensive Care Med 1997; 23: 1212–8.

    Article  PubMed  CAS  Google Scholar 

  76. Schulz O, Mitrovic V, Schonburg M, Thonnann J. High-dose enoximone to evaluate reversibility of pulmonary hypertension: is there a diagnostic value of neurohormonal measurements? Am Heart J 1999; 137: 887–94.

    Article  PubMed  CAS  Google Scholar 

  77. Ouseph R, Brier ME, Jacobs AA, Erbeck KM. Continuous venovenous hemofiltration and hemodialysis after orthotopic heart transplantation. Am J Kidney Dis 1998; 32: 290–4.

    Article  PubMed  CAS  Google Scholar 

  78. Thadhani R, Pascual M, Bonventre JV. Acute renal failure. N Engl J Med 1996; 334: 1448–60.

    Article  PubMed  CAS  Google Scholar 

  79. Lewis RM, Verani RR, Vo C, Katz SM, Van Buren CT, Radovancevic B, Kerman RH, Frazier OH, Kahan BD. Evaluation of chronic renal disease in heart transplant recipients: importance of pretransplantation native kidney histologic evaluation. J Heart Lung Transplant 1994; 13: 376–80.

    PubMed  CAS  Google Scholar 

  80. Textor SC, Wiesner R, Wilson DJ, Porayko M, Romero JC, Burnett JC Jr, Gores G, Hay E, Dickson ER, Krom RA. Systemic and renal hemodynamic differences between FK506 and cyclosporine in liver transplant recipients. Transplantation 1993; 55: 1332–9.

    Article  PubMed  CAS  Google Scholar 

  81. Hummel M, Kuhn M, Bub A, Mann B, Schneider B, von Eickstedt KW, Forssmann WG, Hetzer R. Urodilatin, a new therapy to prevent kidney failure after heart transplantation. J Heart Lung Transplant 1993;12:209–17; discussion 217–8.

    Google Scholar 

  82. Forni LG, Hilton PJ. Continuous hemofiltration in the treatment of acute renal failure. N Engl J Med 1997; 336: 1303–9.

    Article  PubMed  CAS  Google Scholar 

  83. Myers BD, Moran SM. Hemodynamically mediated acute renal failure. N Engl J Med 1986; 314: 97–105.

    Article  PubMed  CAS  Google Scholar 

  84. Scott CD, Dark JH, McComb JM. Sinus node function after cardiac transplantation. J Am Coll Cardiol 1994; 24: 1334–41.

    Article  PubMed  CAS  Google Scholar 

  85. Redmond JM, Zehr KJ, Gillinov MA, Baughman KL, Augustine SM, Cameron DE, Stuart RS, Acker MA, Gardner TJ, Reitz BA. Use of theophylline for treatment of prolonged sinus node dysfunction in human orthotopic heart transplantation. J Heart Lung Transplant 1993;12:133–8; discussion 138–9.

    Google Scholar 

  86. Pavri BB, O’Nunain SS, Newell JB, Ruskin.1N, William G. Prevalence and prognostic significance of atrial arrhythmias after orthotopic cardiac transplantation. J Am Coll Cardiol 1995; 25 1673–80.

    Article  PubMed  CAS  Google Scholar 

  87. Smart FW, Naftel DC, Costanzo MR, Levine TB, Pelletier GB, Yancy CW Jr, Hobbs RE, Kirklin JK, Bourge RC. Risk factors for early, cumulative, and fatal infections after heart transplantation: a multiinstitutional study. J Heart Lung Transplant 1996; 15: 329–41.

    PubMed  CAS  Google Scholar 

  88. Fishman JA, Rubin RH. Infection in organ transplant recipients. N Engl J Med 1998; 338: 1741–51.

    Article  PubMed  CAS  Google Scholar 

  89. George SJ, Vuddamalay P, Boscoe ML Antiseptic-impregnated central venous catheters reduce the incidence of bacterial colonization and associated infection in immunocompromised transplant patients. Eur J Anaesthesiol 1997; 14: 428–31.

    Article  PubMed  CAS  Google Scholar 

  90. Walsh TR, Guttendorf J, Dummer S, Hardesty RL, Armitage JM, Kormos RL, Griffith BP. The value of protective isolation procedures in cardiac allograft recipients. Ann Thorac Surg 1989; 47: 539–44.

    Article  PubMed  CAS  Google Scholar 

  91. Torre-Cisneros J, de la Mata M, Lopez-Cillero P, Sanchez-Guijo P, Mino G, Pera C. Effectiveness of daily low-dose cotrimoxazole prophylaxis for Pneumocystis carinii pneumonia in liver transplantation—an open clinical trial. Transplantation 1996; 62: 1519–21.

    Article  PubMed  CAS  Google Scholar 

  92. Wreghitt TG, Hakim M, Gray JJ, Balfour AH, Stovin PG, Stewart S, Scott J, English TA, Wallwork J. Toxoplasmosis in heart and heart and lung transplant recipients. J Clin Pathol 1989; 42: 194–9.

    Article  PubMed  CAS  Google Scholar 

  93. Balfour HH, Jr., Chace BA, Stapleton JT, Simmons RL, Fryd DS. A randomized, placebo- controlled trial of oral acyclovir for the prevention of cytomegalovirus disease in recipients of renal allografts. N Engl J Med 1989; 320: 1381–7.

    Article  PubMed  Google Scholar 

  94. Merigan TC, Renlund DG, Keay S, Bristow MR, Starnes V, O’Connell JB, Resta S, Dunn D, Gamberg P, Ratkovec RM. A controlled trial of ganciclovir to prevent cytomegalovirus disease after heart transplantation. N Engl J Med 1992; 326: 1182–6.

    Article  PubMed  CAS  Google Scholar 

  95. Gane E, Saliba F, Valdecasa GJ, O’Grady J, Pescovitz MD, Lyman S, Robinson CA. Randomised trial of efficacy and safety of oral ganciclovir in the prevention of cytomegalovirus disease in liver transplant recipients. The Oral Ganciclovir International Transplantation Study Group. Lancet 1997; 350: 1729–33.

    Article  PubMed  CAS  Google Scholar 

  96. Lowance D, Neumayer HH, Legendre CM, Squifflet JP, Kovarik J, Brennan PJ, Norman D, Mendez R, Keating MR, Coggon GL, Crisp A, Lee IC. Valacyclovir for the prevention of cytomegalovirus disease after renal transplantation. International Valacyclovir Cytomegalovirus Prophylaxis Transplantation Study Group. N Engl J Med 1999; 340: 1462–70.

    Article  PubMed  CAS  Google Scholar 

  97. van der Bij W, van Dijk RB, van Son WJ, Torensma R, Prenger KB, Prop J, Tegzess AM, The TH. Antigen test for early diagnosis of active cytomegalovirus infection in heart transplant recipients. J Heart Transplant 1988; 7: 106–9.

    PubMed  Google Scholar 

  98. Tanabe K, Tokumoto T, Ishikawa N, Koyama I, Takahashi K, Fuchinoue S, Kawai T, Koga S, Yagisawa T, Toma H, Ota K, Nakajima H. Comparative study of cytomegalovirus (CMV) antigenemia assay, polymerase chain reaction, serology, and shell vial assay in the early diagnosis and monitoring of CMV infection after renal transplantation. Transplantation 1997; 64: 1721–5.

    Article  PubMed  CAS  Google Scholar 

  99. Lam KM, Oldenburg N, Khan MA, Gaylore V, Mikhail GW, Strouhal PD, Middeldorp JM, Banner N, Yacoub M. Significance of reverse transcription polymerase chain reaction in the detection of human cytomegalovirus gene transcripts in thoracic organ transplant recipients. Journal Heart Lung Transplant 1998; 17: 555–65.

    CAS  Google Scholar 

  100. Rubin RH. Preemptive therapy in immunocompromised hosts. N Engl J Med 1991; 324: 1057–9.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Royal Brompton and Harefield NHS Trust, Harefield, Middlesex, UB9 6JH, UK

    Nicholas R. Banner F.R.C.P., Michael J. Boscoe F.R.C.A. & Asghar Khaghani F.R.C.S.

Authors
  1. Nicholas R. Banner F.R.C.P.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael J. Boscoe F.R.C.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Asghar Khaghani F.R.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Surgical Intensive Care Unit, Department of Surgical Critical Care, Lahey Clinic Medical Center, Burlington, MA, USA

    John Merritt O’Donnell M.D. (Director, Chairman) (Director, Chairman)

  2. Department of Surgical Critical Care, Lahey Clinic Medical Center, Burlington, MA, USA

    Flávio Eduardo Nácul M.D. (Senior Fellow) (Senior Fellow)

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer Science+Business Media New York

About this chapter

Cite this chapter

Banner, N.R., Boscoe, M.J., Khaghani, A. (2001). Postoperative Care of the Heart Transplant Patient. In: O’Donnell, J.M., Nácul, F.E. (eds) Surgical Intensive Care Medicine. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6645-5_48

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-6645-5_48

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-6647-9

  • Online ISBN: 978-1-4757-6645-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation