EARLY POSTOPERATIVE PERIOD AFTER ORTHOTOPIC HEART TRANSPLANTATION IN RECIPIENTS OF 60 YEARS AND OLDER
Introduction. Increase in the number of older patients with terminal CHF results in increase in their proportion among potential recipients requiring mechanical circulatory support and/or heart transplantation (HT) [Abecassis M., Bridges N.D. et al., 2012].Aim. To analyze our own experience of HT in...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2017-01-01
|
| Series: | Vestnik Transplantologii i Iskusstvennyh Organov |
| Subjects: | |
| Online Access: | https://journal.transpl.ru/vtio/article/view/699 |
| _version_ | 1797872043788599296 |
|---|---|
| author | V. N. Poptsov E. A. Spirina S. G. Ukhrenkov S. Yu. Ustin E. Z. Aliev S. A. Masyutin V. Yu. Voronkov N. S. Chibisov D. M. Bondarenko N. Z. Mebonija N. P. Mozheyko A. O. Shevchenko |
| author_facet | V. N. Poptsov E. A. Spirina S. G. Ukhrenkov S. Yu. Ustin E. Z. Aliev S. A. Masyutin V. Yu. Voronkov N. S. Chibisov D. M. Bondarenko N. Z. Mebonija N. P. Mozheyko A. O. Shevchenko |
| author_sort | V. N. Poptsov |
| collection | DOAJ |
| description | Introduction. Increase in the number of older patients with terminal CHF results in increase in their proportion among potential recipients requiring mechanical circulatory support and/or heart transplantation (HT) [Abecassis M., Bridges N.D. et al., 2012].Aim. To analyze our own experience of HT in recipients of older 60 years.Materials and methods. The study included 63 patients (56 men (93.3% ) and 4 (6.7%) women) aged 60–74 years (63.0 ± 0.8) with body weight of 76.6 ± 1.4 kg, body surface area of 1.7 ± 0.02 m2, and body mass index of 23.4 ± 0.6. Indications for heart transplantation: dilated cardiomyopathy – 24 (38.1%), coronary heart disease – 34 (54.0%), hypertrophic cardiomyopathy – 2 (3.2%), irreversible cardiac graft dysfunction – 3 (4.7%). 46 (73.0%) patients had NYHA functional Class III and 17 (23.0%) patients – Class IV. Transpulmonary pressure gradient was 11.2 ± 2.7 mmHg, pulmonary vascular resistance – 3.5 ± 1.3 Wood units. According to UNOS algorithm 10 (15.9%) patients were listed as Status 1A of urgency of orthotopic cardiac transplantation (VA ECMO, n = 8, and implantable left ventricular assist device, n = 2), 21 (33.3%) patients as Status 1B, and 32 (50.8%) patients as Status 2. Recipients had the following comorbidities: arterial hypertension (n = 51; 81.0%), diabetes mellitus (n = 6; 9.5%), cerebrovascular disease (n = 13; 20.6%), history of stroke (n = 9; 14.3%), dialysisindependent renal dysfunction (n = 21; 33.3%). Before cardiac transplantation 9 (14.2%) recipients underwent various thoracic surgeries, 2 (3.2%) recipients – brain surgery. Heart donors (49 (77.8%) men and 14 (22.2%) women) were aged 18–59 (34.3 ± 10.4) years.Results. ICU hospitalization lasted for 4–15 (8.2 ± 0.5) days. In 61.9% of cases (n = 39) early postoperative and hospital periods were uncomplicated. Early on-table postoperative activation («early» tracheal extubation) was performed in 32 (50.8%) patients in 48 ± 6 minutes after surgery completion. 2 (3.2%) recipients demonstrated early graft dysfunction and required VA ECMO. Complications other than graft dysfunction were in 24 (38.1%) recipients: renal dysfunction (n = 8; 12.7%), renal and hepatic dysfunction (n = 4; 6.3%), infections (bacterial pneumonia, n = 3, [4.8%]), dyscirculatory encephalopathy (n = 9; 14.3%). 12 (19.0%) patients required continuous renal replacement therapy, 10 of them (15.9%) demonstrated renal function recovery. In 2 (3.2%) cases long-term hemodialysis was used. Hospital lethality (n = 6; 9.5%) was due to multiple organ failure syndrome and sepsis.Conclusion. Our own experience demonstrates satisfactory short-term and long-term survival after heart transplantation in recipients of 60 years and older. |
| first_indexed | 2024-04-10T00:53:37Z |
| format | Article |
| id | doaj.art-fe301d734a83491aa489360ff9a59106 |
| institution | Directory Open Access Journal |
| issn | 1995-1191 |
| language | Russian |
| last_indexed | 2024-04-10T00:53:37Z |
| publishDate | 2017-01-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Vestnik Transplantologii i Iskusstvennyh Organov |
| spelling | doaj.art-fe301d734a83491aa489360ff9a591062023-03-13T10:37:23ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovVestnik Transplantologii i Iskusstvennyh Organov1995-11912017-01-01184566510.15825/1995-1191-2016-4-56-65583EARLY POSTOPERATIVE PERIOD AFTER ORTHOTOPIC HEART TRANSPLANTATION IN RECIPIENTS OF 60 YEARS AND OLDERV. N. Poptsov0E. A. Spirina1S. G. Ukhrenkov2S. Yu. Ustin3E. Z. Aliev4S. A. Masyutin5V. Yu. Voronkov6N. S. Chibisov7D. M. Bondarenko8N. Z. Mebonija9N. P. Mozheyko10A. O. Shevchenko11V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation I.M. Sechenov First Moscow State Medical UniversityIntroduction. Increase in the number of older patients with terminal CHF results in increase in their proportion among potential recipients requiring mechanical circulatory support and/or heart transplantation (HT) [Abecassis M., Bridges N.D. et al., 2012].Aim. To analyze our own experience of HT in recipients of older 60 years.Materials and methods. The study included 63 patients (56 men (93.3% ) and 4 (6.7%) women) aged 60–74 years (63.0 ± 0.8) with body weight of 76.6 ± 1.4 kg, body surface area of 1.7 ± 0.02 m2, and body mass index of 23.4 ± 0.6. Indications for heart transplantation: dilated cardiomyopathy – 24 (38.1%), coronary heart disease – 34 (54.0%), hypertrophic cardiomyopathy – 2 (3.2%), irreversible cardiac graft dysfunction – 3 (4.7%). 46 (73.0%) patients had NYHA functional Class III and 17 (23.0%) patients – Class IV. Transpulmonary pressure gradient was 11.2 ± 2.7 mmHg, pulmonary vascular resistance – 3.5 ± 1.3 Wood units. According to UNOS algorithm 10 (15.9%) patients were listed as Status 1A of urgency of orthotopic cardiac transplantation (VA ECMO, n = 8, and implantable left ventricular assist device, n = 2), 21 (33.3%) patients as Status 1B, and 32 (50.8%) patients as Status 2. Recipients had the following comorbidities: arterial hypertension (n = 51; 81.0%), diabetes mellitus (n = 6; 9.5%), cerebrovascular disease (n = 13; 20.6%), history of stroke (n = 9; 14.3%), dialysisindependent renal dysfunction (n = 21; 33.3%). Before cardiac transplantation 9 (14.2%) recipients underwent various thoracic surgeries, 2 (3.2%) recipients – brain surgery. Heart donors (49 (77.8%) men and 14 (22.2%) women) were aged 18–59 (34.3 ± 10.4) years.Results. ICU hospitalization lasted for 4–15 (8.2 ± 0.5) days. In 61.9% of cases (n = 39) early postoperative and hospital periods were uncomplicated. Early on-table postoperative activation («early» tracheal extubation) was performed in 32 (50.8%) patients in 48 ± 6 minutes after surgery completion. 2 (3.2%) recipients demonstrated early graft dysfunction and required VA ECMO. Complications other than graft dysfunction were in 24 (38.1%) recipients: renal dysfunction (n = 8; 12.7%), renal and hepatic dysfunction (n = 4; 6.3%), infections (bacterial pneumonia, n = 3, [4.8%]), dyscirculatory encephalopathy (n = 9; 14.3%). 12 (19.0%) patients required continuous renal replacement therapy, 10 of them (15.9%) demonstrated renal function recovery. In 2 (3.2%) cases long-term hemodialysis was used. Hospital lethality (n = 6; 9.5%) was due to multiple organ failure syndrome and sepsis.Conclusion. Our own experience demonstrates satisfactory short-term and long-term survival after heart transplantation in recipients of 60 years and older.https://journal.transpl.ru/vtio/article/view/699heart transplantationolder recipientsmechanical circulatory support |
| spellingShingle | V. N. Poptsov E. A. Spirina S. G. Ukhrenkov S. Yu. Ustin E. Z. Aliev S. A. Masyutin V. Yu. Voronkov N. S. Chibisov D. M. Bondarenko N. Z. Mebonija N. P. Mozheyko A. O. Shevchenko EARLY POSTOPERATIVE PERIOD AFTER ORTHOTOPIC HEART TRANSPLANTATION IN RECIPIENTS OF 60 YEARS AND OLDER Vestnik Transplantologii i Iskusstvennyh Organov heart transplantation older recipients mechanical circulatory support |
| title | EARLY POSTOPERATIVE PERIOD AFTER ORTHOTOPIC HEART TRANSPLANTATION IN RECIPIENTS OF 60 YEARS AND OLDER |
| title_full | EARLY POSTOPERATIVE PERIOD AFTER ORTHOTOPIC HEART TRANSPLANTATION IN RECIPIENTS OF 60 YEARS AND OLDER |
| title_fullStr | EARLY POSTOPERATIVE PERIOD AFTER ORTHOTOPIC HEART TRANSPLANTATION IN RECIPIENTS OF 60 YEARS AND OLDER |
| title_full_unstemmed | EARLY POSTOPERATIVE PERIOD AFTER ORTHOTOPIC HEART TRANSPLANTATION IN RECIPIENTS OF 60 YEARS AND OLDER |
| title_short | EARLY POSTOPERATIVE PERIOD AFTER ORTHOTOPIC HEART TRANSPLANTATION IN RECIPIENTS OF 60 YEARS AND OLDER |
| title_sort | early postoperative period after orthotopic heart transplantation in recipients of 60 years and older |
| topic | heart transplantation older recipients mechanical circulatory support |
| url | https://journal.transpl.ru/vtio/article/view/699 |
| work_keys_str_mv | AT vnpoptsov earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT easpirina earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT sgukhrenkov earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT syuustin earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT ezaliev earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT samasyutin earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT vyuvoronkov earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT nschibisov earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT dmbondarenko earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT nzmebonija earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT npmozheyko earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder AT aoshevchenko earlypostoperativeperiodafterorthotopichearttransplantationinrecipientsof60yearsandolder |