Open AccessJournal Article
Hemodynamics during humoral rejection events with total versus standard orthotopic heart transplantation.
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TLDR
ToHT offers improved hemodynamics during humoral rejection as evidenced by higher cardiac output and index with lower right atrial and pulmonary capillary wedge pressures.Abstract:
Purpose: We hypothesized that total orthotopic heart transplantation (TOHT) improves humoral rejection hemodynamics compared with biatrial transplantation or standard orthotopic heart transplantation (SOHT). Methods: We reviewed 1942 biopsies from 134 patients (pts) and right heart catheterization data obtained at endomyocardial biopsy. Biopsies that displayed humoral rejection by histological findings and positive immunofluorescence for immunoglobulins and complement were analyzed. Patients with pacemakers, atrial fibrillation or -blocker therapy at the time of biopsy were excluded. Thirty-two pts after TOHT and 22 after SOHT matching these criteria were identified. Results: Demographic data, underlying disease, pretransplant hemodynamics, and donor demographics were similar. Cardiac output and index were higher in the total orthotopic group (5.9±1.1 vs 5.1±1.4 L/min, p=0.027; 3.3±0.5 vs 2.8±0.6 L/min/m 2 , p=0.016). Right atrial and pulmonary capillary wedge pressure were lower after TOHT (7±3 vs 11±5 mmHg, p<0.001; 13±4 vs 16±5 mmHg, p=0.035). Pulmonary pressures, pulmonary vascular resistance and heart rate were similar. Conclusion: TOHT offers improved hemodynamics during humoral rejection as evidenced by higher cardiac output and index with lower right atrial and pulmonary capillary wedge pressures. Future studies must examine the potential benefits of TOHT during combined cellular and humoral rejection events. (Ann Thorac Cardiovasc Surg 2004; 10: 285‐9)read more
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Heart transplantation for end-stage heart failure due to cardiac sarcoidosis.
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Survival and allograft rejection rates after combined heart and kidney transplantation in comparison with heart transplantation alone
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TL;DR: Patients who are aged 70 years and older can undergo heart transplantation with similar morbidity and mortality when compared with younger recipients, and should not be excluded from transplant consideration based solely on an age criterion.
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Adult Heart Transplantation Following Ventricular Assist Device Implantation: Early and Late Outcomes.
M. Awad,Lawrence S.C. Czer,M. De Robertis,James Mirocha,A. Ruzza,Matthew Rafiei,Heidi Reich,Alfredo Trento,J. D. Moriguchi,Jon A. Kobashigawa,Fardad Esmailian,Francisco A. Arabia,Danny Ramzy +12 more
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References
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Journal Article
Studies on orthotopic homotransplantation of the canine heart.
Journal ArticleDOI
Humoral rejection in cardiac transplantation: risk factors, hemodynamic consequences and relationship to transplant coronary artery disease.
Paul J Michaels,Maria L. Espejo,Jon A. Kobashigawa,Juan C. Alejos,C. Burch,Takemoto S,Elaine F. Reed,Michael C. Fishbein +7 more
TL;DR: Humoral rejection is a clinicopathologic entity with a high incidence in women and is associated with acute hemodynamic compromise, accelerated transplant coronary artery disease and death.
Journal Article
Vascular (humoral) rejection in heart transplantation: pathologic observations and clinical implications.
Elizabeth H. Hammond,Yowell Rl,Nunoda S,Ronald L. Menlove,Dale G. Renlund,Michael R. Bristow,Kent W. Jones,John B. O'Connell +7 more
TL;DR: It is concluded that immunofluorescence should be routinely done on all heart biopsies for the first month after transplantation, because patients with vascular (humoral) rejection cannot be reliably identified by any other means.
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Time course of resolution of pulmonary hypertension and right ventricular remodeling after orthotopic cardiac transplantation.
Satinder J.S. Bhatia,James M. Kirshenbaum,Richard J. Shemin,Lawrence H. Cohn,John J. Collins,V J Di Sesa,P J Young,Gilbert H. Mudge,M G Sutton +8 more
TL;DR: There is rapid resolution of moderately elevated pulmonary arterial pressures after cardiac transplantation, and echocardiographic analysis showed that transplant recipients had an enlarged right ventricle on day 1 after surgery, and a volume overload contraction pattern and tricuspid regurgitation was present in the majority.
Journal ArticleDOI
Total orthotopic heart transplantation: an alternative to the standard technique.
TL;DR: An alternative technique of total orthotopic heart transplantation is described, where complete excision of the recipient's atria is undertaken.