Perioperative management of patients with heart transplantation: a report of 30 cases
- VernacularTitle:原位心脏移植30例临床分析
- Author:
Jie HAN
;
Xu MENG
;
Haibo ZHANG
- Publication Type:Journal Article
- Keywords:
Heart transplantation;
Intraoperative period;
Treatment outcome
- From:
Chinese Journal of Organ Transplantation
2005;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To sum up the experience of perioperative management of patients with heart transplantation.Methods In recent 3 years 24 cases of dilated cardiomyopathy,4 cases of(serious) valve disease,1 case of serious ischemic cardiomyopathy and 1 case of bi-ventricular assist(received) heart transplantation surgery.The mean by pass time was 75?24 min and the mean aortic clamp time was 72?8 min.Cyclosporine,MMF and prenisodone were adopted as anti-immune(response) strategy and the dose of cyclosporine was adjusted according to the serum concentration.(Intramyocardial) electrograms and tissue Doppler ultrasound technique were used to monitor the(immune) response situation.The myocardial biopsy was performed in case of the suspect of acute(rejection).Results In 5 postoperative deaths,3 cases died of low cardiac output,1 died of infection-(induced) multiple organ failure and 1 case died of serious bleeding.The postoperative complications(included) right heart failure in 6 cases,renal failure in 13 cases,and acute rejection in 4 cases.(Conclusion) The effective prevention and management of complications is the key point of success of heart transplantation.Application of comprehensive monitoring techniques is beneficial to the management of the immune rejection after transplantation.