Intensive Care Unit and Stepdown Management

Living reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


Heart transplant is the definitive treatment for patients with end-stage heart failure. Patients who undergo a transplant have the same physiologic burden as typical cardiac procedures with the added strain of organ transplant and immunosuppression. In this chapter, current principles in the postoperative management of the heart transplant patient are discussed. This includes a systematic review of surgical issues presenting in the immediate postoperative period and the physiological perturbations unique to the transplant patient. Standard of care in hemodynamic monitoring and mechanical ventilatory support methods are discussed with a focus on the postoperative transplant patient. Management of hemodynamic instability and common arrhythmias occurring in the perioperative period will be discussed with a review of pharmacological and mechanical approaches used in the management of these problems. Finally, nutritional guidelines pertaining to postcardiotomy patients with specific recommendations related to the transplant patient are reviewed.


Heart transplant Cardiac surgery Cardiac critical care Heart failure Intensive care 


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Authors and Affiliations

  1. 1.University of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Department of Cardiothoracic SurgeryUniversity of PittsburghPittsburghUSA

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