The results of orthotopic heart transplantation using the bicaval technique

Authors

DOI:

https://doi.org/10.34287/MMT.2(57).2023.1

Abstract

Circulatory failure, which develops in the final stages of the course of the most heart diseases, is a link in the progressive process. This process is accompanied by a significant decrease in the quality of life, as well as high disability and mortality.

Heart transplantation increases the survival of patients with chronic heart failure, increases tolerance to physical exertion, improves the quality of life of patients and allows most of them to return to vigorous activity.

Aim. The work is devoted to the analysis of the results of orthotopic heart transplantation in patients with a progressive course of chronic heart failure that cannot be treated conservatively.

Materials and methods. We analyzed the clinical course of heart transplants in 55 patients. There were 46 (83.6 %) men and 9 (16.4 %) women among the recipients. The average age was 46.0 ± 10.0 years.

Results. The result of the conducted retrospective study revealed that in-hospital (early) and one-year (longterm) survival among patients in our study was 92.7 % and 81.8 %, respectively.

Conclusions. Heart transplantation is the most effective method of treatment for terminal heart failure. The quality of life of heart transplant patients improves significantly after surgery and is the main factor in the development of heart transplantation nowadays.

The main causes of death were acute graft dysfunction, rejection reactions, and coronary heart disease of the transplanted heart. Problems related to cardiac graft dysfunction and rejection in the early and long-term period still need to be definitively resolved.

References

Shah KS, Kittleson MM, Kobashigawa JA. Updates on Heart Transplantation. Curr Heart Fail Rep. 2019;16(5):150-6. doi: 10.1007/s11897-019-00432-3.

Vieira JL, Mehra MR. Heart transplantation candidacy. Curr Opin Organ Transplant. 2021;26(1):69-76. doi: 10.1097/MOT.0000000000000828.

Khush KK, Potena L, Cherikh WS, Chambers DC, Harhay MO, Hayes D Jr, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: 37th adult heart transplantation report-2020; focus on deceased donor characteristics. J Heart Lung Transplant. 2020;39(10):1003-15. doi: 10.1016/j.healun.2020.07.010.

Khush KK, Hsich E, Potena L, Cherikh WS, Chambers DC, Harhay MO, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-eighth adult heart transplantation report 2021; Focus on recipient characteristics. J Heart Lung Transplant. 2021;40(10):1035-49. doi: 10.1016/j.healun.2021.07.015.

Scheuer SE, Jansz PC, Macdonald PS. Heart transplantation following donation after circulatory death: Expanding the donor pool. J Heart Lung Transplant. 2021;40(9):882-9. doi: https://doi.org/10.1016/j.healun.2021.03.011.

Quader M, Toldo S, Chen Q, Hundley G, Kasirajan V. Heart transplantation from donation after circulatory death donors: Present and future. J Card Surg. 2020;35(4):875-885. doi: 10.1111/jocs.14468.

Vokshi I, Large S, Berman M, Tsui S. Heart transplantation from an extended criteria donation after circulatory death donor. Eur J Cardiothorac Surg. 2022 11;62(2):ezac083. doi: 10.1093/ejcts/ezac083.

Khush KK. Donor selection in the modern era. Ann Cardiothorac Surg. 2018;7(1):126-134. doi: 10.21037/acs.2017.09.09.

Cohn JN, Rector TS. Prognosis of congestive heart failure and predictors of mortality. Am J Cardiol. 1988;62(2):25A-30A. doi: 10.1016/s0002- 9149(88)80081-x.

Jeevanandam V. Improving the metrics for donor heart sizing. J Card Surg. 2021;36(9):3250. doi: 10.1111/jocs.15752.

Patel MS, Abt PL. Current practices in deceased organ donor management. Curr Opin Organ Transplant. 2019;24(3):343-50. doi: 10.1097/ MOT.0000000000000638.

Yan M, Shang H, Hao L, Guo X, Zheng H, Li H, et al. A preliminary study of dobutamine myocardial flow reserve on 99mTc-Sestamibi CZT-SPECT. Annals of Nuclear Medicine. 2023;37(6):349-59. doi: 10.1007/s12149-023-01829-w.

Goel R, Johnson F, Mehra MR. Brain injury and ventricular dysfunction: insights into reversible heart failure. Congest Heart Fail. 2005;11(2):99-101. doi: 10.1111/j.1527-5299.2005.04178.x.

Nguyen VP, Mahr C, Mokadam NA, Pal J, Smith JW, Dardas TF. The Benefit of Donor-Recipient Matching for Patients Undergoing Heart Transplantation. J Am Coll Cardiol. 2017;69(13):1707-14. doi: 10.1016/j.jacc.2017.01.038.

Zheng S, Tang H, Zheng Z, Song Y, Huang J, Liao Z, et al. Validation of existing risk scores for mortality prediction after a heart transplant in a Chinese population. Interact Cardiovasc Thorac Surg. 2022;34(5):909-18. doi: 10.1093/icvts/ivab380.

Shudo Y, Wang H, Lingala B, He H, Kim FY, Hiesinger W, et al. Evaluation of Risk Factors for Heart-Lung Transplant Recipient Outcome: An Analysis of the United Network for Organ Sharing Database. Circulation. 2019;140(15):1261-72. doi: 10.1161/CIRCULATIONAHA.119.040682.

Sorabella RA, Guglielmetti L, Kantor A, Castillero E, Takayama H, Schulze PC, et al. Cardiac donor risk factors predictive of short-term heart transplant recipient mortality: an analysis of the United Network for Organ Sharing Database. Transplant Proc. 2015;47:2944-51. doi: 10.1016/j. transproceed.2015.10.021.

Chen Q, Kobashigawa J, Emerson D, Singer-Englar T, Megna D, Ramzy D, et al. Heart Transplantation With Older Donors: Should There Be an Age Cutoff? Transplant Proc. 2022;54(8):2088-96. doi: 10.1016/j.transproceed.2022.07.004.

Prieto D, Correia P, Baptista M, Antunes MJ. Outcome after heart transplantation from older donor age: expanding the donor pool. Eur J Cardiothorac Surg. 2015;47(4):672-8. doi: 10.1093/ejcts/ezu257.

Del Rizzo DF, Menkis AH, Pflugfelder PW, Novick RJ, McKenzie FN, Boyd WD, et al. The role of donor age and ischemic time on survival following orthotopic heart transplantation. J Heart Lung Transplant. 1999;18(4):310-9. doi: 10.1016/s1053-2498(98)00059-x.

Sunjaya AF, Sunjaya AP. Combating Donor Organ Shortage: Organ Care System Prolonging Organ Storage Time and Improving the Outcome of Heart Transplantations. Cardiovasc Ther. 2019;2019:9482797. doi: 10.1155/2019/9482797.

Zinn MD. Is it time to change the routine for surveillance endomyocardial biopsy after pediatric heart transplantation? Pediatr Transplant. 2021;25(7):e14080. doi: 10.1111/petr.14080.

Piening BD, Dowdell AK, Zhang M, Loza BL, Walls D, Gao H, et al. Whole transcriptome profiling of prospective endomyocardial biopsies reveals prognostic and diagnostic signatures of cardiac allograft rejection. J Heart Lung Transplant. 2022;41(6):840-8. doi: 10.1016/j.healun.2022.01.1377.

Kourek C, Karatzanos E, Nanas S, Karabinis A, Dimopoulos S. Exercise training in heart transplantation. World J Transplant. 2021;11(11):466-79. doi: 10.5500/wjt.v11.i11.466.

Bockus L, Kim F. Coronary endothelial dysfunction: from pathogenesis to clinical implications. Open Heart. 2022;9(2):e002200. doi: 10.1136/ openhrt-2022-002200.

Stehlik J, Edwards LB, Kucheryavaya AY, Benden C, Christie JD, Dipchand AI, et al. The Registry of the International Society for Heart and Lung Transplantation: 29th official adult heart transplant report--2012. J Heart Lung Transplant. 2012;31(10):1052-64. doi: 10.1016/j.healun.2012.08.002.

Langstraat M, Musters KJS, Manintveld O, Masetti M, Potena L. Coronary artery disease in heart transplantation: new concepts for an old disease. Transpl Int. 2018;31(8):787-827. doi: 10.1111/tri.13141.

Narang A, Blair JE, Patel MB, Mor-Avi V, Fedson SE, Uriel N, et al. Myocardial perfusion reserve and global longitudinal strain as potential markers of coronary allograft vasculopathy in late-stage orthotopic heart transplantation. Int J Cardiovasc Imaging. 2018;34(10):1607-17. doi: 10.1007/s10554- 018-1364-7.

Heil KM, Helmschrott M, Darche FF, Bruckner T, Ehlermann P, Kreusser MM, et al. Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation. Life (Basel). 2021;11(12):1344. doi: 10.3390/life11121344.

Asleh R, Alnsasra H, Habermann TM, Briasoulis A, Kushwaha SS. Post-transplant Lymphoproliferative Disorder Following Cardiac Transplantation. Front Cardiovasc Med. 2022;9:787975. doi: 10.3389/fcvm.2022.787975.

Albayati A, Ozkan B, Eyuboglu AA, Uysal AC, Markal Ertas N, Haberal M. Nonmelanoma Skin Cancers in Solid-Organ Transplant Recipients: A Single Center Experience. Exp Clin Transplant. 2018;16(Suppl 1):95-100. doi: 10.6002/ect.TOND-TDTD2017.O36.

Downloads

Published

2023-06-20

How to Cite

Todurov, B. M. ., Kovtun, H. I., Loskutov, O. A., Maruniak, S. R., Loskutov, D. O., & Melnyk, A. Y. . (2023). The results of orthotopic heart transplantation using the bicaval technique. Modern Medical Technology, (2), 5–11. https://doi.org/10.34287/MMT.2(57).2023.1

Issue

Section

Original research