Non-cardiac Surgery in Patients with Heart Transplants - Anesthetic and Operative Considerations

  • E. Becerha
  • D. K. C. Cooper


As cardiac transplantation becomes increasingly successful there is a growing possibility that patients with heart transplants may require surgery for conditions unrelated to the heart. Such patients clearly present special management problems, which include, in particular, atypical responses to both stress and certain pharmacological agents, and increased susceptibility to infection.


Abdominal Aortic Aneurysm Cardiac Transplantation Endomyocardial Biopsy Noncardiac Surgery Heart Lung Transplant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Steed DL, Brown B, Reilly JJ et al. General surgical complications in heart and heart-lung transplantation. Surgery. 1985;98:739.PubMedGoogle Scholar
  2. 2.
    Cooper DKC, Becerra HA, Novitzky D et al. Surgery in patients with heart transplants: anaesthetic and operative considerations. S Air Med J. 1986;70:137.Google Scholar
  3. 3.
    Samuels SI, Wyner J. Anaesthesia for surgery in patients with a transplanted heart. Br J Anaesth. 1986;58:1119.CrossRefGoogle Scholar
  4. 4.
    Parascandola SA, Wisman CB, Burg JE, Davis PK. Extracardiac surgical complications in heart transplant recipients. J Heart Transplant. 1989;8:400.PubMedGoogle Scholar
  5. 5.
    Merrell SW, Ames SA, Nelson EW et al. Major abdominal complication following cardiac transplantation. Utah Transplantation Affiliated Hospitals Cardiac Transplant Program. Arch Surg. 1989;124:889.PubMedGoogle Scholar
  6. 6.
    Melendez JA, Delphin E, Lamb J, Rose H. Noncardiac surgery in heart transplant recipients in the cyclosporin era. Cardiothorac Vasc Anesth. 1991;5:218.CrossRefGoogle Scholar
  7. 7.
    Watson CJE, Jamieson NV, Johnston PS et al. Early abdominal complications following heart and heart king transplantation. Br J Surg. 1991;78:699.PubMedCrossRefGoogle Scholar
  8. 8.
    Steck TB, Durkin MG, Costanzo-Nordin MR, Keshavarzian A. Gastrointestinal complications and endoscopic finding in heart transplant patients. J Heart Lung Transplant. 1993;12:244.PubMedGoogle Scholar
  9. 9.
    Teixido M, Kron TK, Plainse M. Head and neck sequelae of cardiac transplantation. Laryngoscope, 1990;100:231.PubMedCrossRefGoogle Scholar
  10. 10.
    Razzouk AJ. Surgical intervention in children after heart transplantation. J Heart Lung Transplant. 1993;12:S195.PubMedGoogle Scholar
  11. 11.
    Nguyen DM, Tchervenkov CI, Latter D et al. Successful repair of recurrent coactation after neonatal heart transplantation. J Heart Lung Transplant. 1994;13:919.PubMedGoogle Scholar
  12. 12.
    Piotrowski JJ, McIntyre KL, Hunter CG et al. Abdominal aortic aneurysm in the patient undergoing cardiac transplantation. J Vasc Surg. 1991;14:460.PubMedCrossRefGoogle Scholar
  13. 13.
    Benvenisly AI, Todd GJ, Argenziano M et al. Management of peripheral vascular problems in recipients of cardiac allografts. J Vasc Surg. 1992;16:895.CrossRefGoogle Scholar
  14. 14.
    Steck TB, Constanzo-Nordin MR, Keshavarzian A. Prevalence and management of cholelithiasis in heart transplant patients. J Heart Lung Transplant. 1991;10:1029.PubMedGoogle Scholar
  15. 15.
    Girardet RE, Rosenbloom P, DeWeese BM et al. Significance of asymptomatic biliary tract disease in heart transplant recipients. J Heart Transplant. 1989;8:391.PubMedGoogle Scholar
  16. 16.
    Spes CH, Angermann CE, Beyer RW et al. Increased incidence of cholelithiasis in heart transplant recipients receiving cyclosporin therapy. J Heart Transplant. 1990;9:404.PubMedGoogle Scholar
  17. 17.
    Bramwell NH, Davies RA, Koshal A et al. Fatal gastrointestinal hemorrhage caused by cytomegalovirus duodenitis and ulceration after heart transplantation. J Heart Transplant. 1987;6:303.PubMedGoogle Scholar
  18. 18.
    Yoshimura N, Nakai I, Ohmiri Y et al. Effect of cyclosporin on the endocrine and exocrine pancreas in kidney transplant recipients. Am J Kidney Dis. 1988;12:11.PubMedGoogle Scholar
  19. 19.
    Lorber MI, Van Buren CT, Flechner SM, Williams C, Kahan BD. Hepatobiliary and pancreatic complications of cyclosporin therapy in 466 renal transplant recipients. Transplantation. 1987;43:35.PubMedCrossRefGoogle Scholar
  20. 20.
    Sturdevant RA, Singleton JW, Deren JJ, Law DH, McCleery JL. Azathioprine-related pancreatitis in patients with Crohn’s disease. Gastroenterology. 1979;77:883.PubMedGoogle Scholar
  21. 21.
    Mallory A, Kern F. Drug-induced pancreatitis: a critical review. Gastroenterology. 1980;78:813.PubMedGoogle Scholar
  22. 22.
    Levine RA, McGuire RF. Corticosteroid-indueed pancreatitis: a case report demonstrating recurrence with rechallenge. Am J Gastroenterol. 1988;83:1161.PubMedGoogle Scholar
  23. 23.
    Bourne MS, Dawson H. Acute pancreatitis complicating prednisolone therapy. Lancet. 1958;2:1209.PubMedCrossRefGoogle Scholar
  24. 24.
    Kawanishi H, Rudolph E, Bull F. Azathioprine induced acute pancreatitis. N Engl J Med. 1973;289:357.PubMedCrossRefGoogle Scholar
  25. 25.
    Parham DM. Post-transplantation pancreatitis associated with cytomegalovirus. Hum Pathol. 1981;12:663.PubMedCrossRefGoogle Scholar
  26. 26.
    Magreitier R, Schmid T, Dunser M et al. Cytomegalovirus (CMV)-pancreatitis: a rare complication after pancreas transplantation. Transplant Proc. 1991;23:1619.Google Scholar
  27. 27.
    Missavage A, Weaver D, Bouwman D, Parnel V, Wilson R, Hyperamylusemia after cardiopulmonary bypass. Am Surg. 1984;50:297.PubMedGoogle Scholar
  28. 28.
    Schroeder JS, Berke DK, Graham AF, Harrison DC. Arrhythmias after cardiac transplantation. Am J Cardiol. 1974;33:604.PubMedCrossRefGoogle Scholar
  29. 29.
    Eisenkraft JB, Dimich I, Sachdev VP. Anesthesia for major non-cardiac surgery in patients with a transplanted heart. Mount Sinai J Med (NY). 1981;48:116.Google Scholar
  30. 30.
    Cirella V, Pantuck C, Pantuck G et al. Effects of cyclosporin on anesthetic action. Anesth Analg. 1987;66:703.PubMedCrossRefGoogle Scholar
  31. 31.
    Frater RWM, Santos GH. Sources of infection in open heart surgery. NY State J Med. 1974;74:2386.Google Scholar
  32. 32.
    Kluge RM, Calia FM, McLaughlin JS, Hornick RB. Sources of contamination in open heart surgery. J Am Med Assoc. 1974;230:1415.CrossRefGoogle Scholar
  33. 33.
    Dretchen KL, Morgenroth VH, Standaert KG, Walts LF. Azathioprine effects on neuromuscular transmission. Anesthesiology. 1976;45:604.PubMedCrossRefGoogle Scholar
  34. 34.
    Reitz BA, Baumgartner WA, Over PF, Stinson HB. Abdominal aortic aneurysmectomy in long-term cardiac transplant survivors. Arch Surg. 1977;112:1057.PubMedGoogle Scholar
  35. 35.
    Isono SS, Woolson ST, Schurman DJ. Total joint arthroplasty for steroid-induced osleonecrosis in cardiac transplant patients. Clin Orthop. 1987;217:201.PubMedGoogle Scholar
  36. 36.
    Aarnio P, Harjula A, Heikkila L, Matilla S. Surgery after heart transplantation. Transplant Proc. 1990;22:190.PubMedGoogle Scholar
  37. 37.
    Carroll BJ, Chandra M, Phillips EH, Hamid JG. Laparoscopic cholecystectomy in the heart transplant candidate with acute cholecystitis. J Heart Lung Transplant. 1992;11:831.PubMedGoogle Scholar
  38. 38.
    Lopez P, Perrone SV, Kaplan J et al. Laparoscopic cholecystectomy in heart transplant recipients. J Heart Lung Transplant. 1993;12:147.PubMedGoogle Scholar
  39. 39.
    Boline GB, Gifford RRM, Yang HC et al. Cholecystectomy in the potential heart transplant patient. J Heart Lung Transplant. 1991;10:269.PubMedGoogle Scholar
  40. 40.
    Oaks TE, Pae WE, Pennock JL, Myers JL, Pierce WS. Aortic rupture caused by fungal aortitis: successful management after heart transplantation, J Heart Lung Transplant. 1988;7:162.Google Scholar
  41. 41.
    Reichman W, Dyke C, Lee HM et al. Symptomatic abdominal aortic aneurysms in long-term survivors of cardiac transplantation. J Vasc Surg. 1990;11:476.PubMedCrossRefGoogle Scholar
  42. 42.
    Hertzer NR. Basic data concerning associated coronary disease in peripheral vascular patients. Ann Vasc Surg. 1990;1:616.CrossRefGoogle Scholar
  43. 43.
    Hertzer NR. Fatal myocardial infarction following abdominal aortic ancurysm re-section: three hundred forty three patients followed 6–11 years postoperatively. Ann Surg. 1980;192:667.PubMedGoogle Scholar
  44. 44.
    Blombery PA, Ferguson IA., Rosengarten DS, et al. The role of coronary artery disease in complications of abdominal aortic aneurysm surgery. Surgery. 1987;101:150.PubMedGoogle Scholar
  45. 45.
    Roger VL, Ballard DJ, Hallet JW et al. Influence of coronary artery disease on morbidity and mortality after abdominal aortic aneurysmectomy: a population-based study, 1971–1987. J Am Coll Cardiol. 1989;14:1245.PubMedCrossRefGoogle Scholar
  46. 46.
    Kanter SF, Samuels SI. Anesthesia for major operations on patients who have transplanted hearts: a review of 29 eases. Anesthesiology. 1977;46:65.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • E. Becerha
  • D. K. C. Cooper

There are no affiliations available

Personalised recommendations