Careaga-Reyna G, Jiménez-Valdivia M, Argüero-Sánchez R

Language: Spanish
References: 21
Page: 344-349
PDF size: 80.96 Kb.

ABSTRACT

Background. Heart transplantation is a treatment which has modified the long-term, survival en terminal heart failure patients. The objective of this work is to inform our experience with this surgical procedure. Material and methods. We analyzed the heart transplants realized between January 1, 1993 and November 30, 2004, the surgical techniques for harvest and implant and the procedure of heart preservation. The conventional approach for harvesting was median sternotomy with celiotomy in multiorgan donation. In main cases for preservation, we used the Bretschneider solution at 30 cc/ kg and 4 °C of temperature. For the implant of the heart the surgical techniques were biatrial or bicaval anastomosis. Results. A total of 16 heart transplantation was realized. The mean age of the recipients was 41 year-old (range: 15 a 57). In 68.7% the indication for the procedure was dilated idiopathic cardiomyopathy. The ischemic period was 154.6 ± 63.9 min. There were 4 harvesting procedures out of the city. In 4 cases we used biatrial anastomosis, and in the other patients the bicaval procedure. We have three deaths for primary organ failure. The one-year survival was 80.2%. Conclusion. Heart transplantation is a therapeutic option to improves long-term, survival in heart failure patients, and the results with the procedure we use are comparable to others around the world.

REFERENCES

1. Argüero R, Archundia A, Barragán R, Careaga G, Elizondo LA, Garrido M, Lepe L, Verdín R. Cirugía (I Consenso Nacional de Insuficiencia Cardiaca). Rev Mex Cardiol 2000; 11: 270-4.

2. English TAH, Spratt P, Wallwork J, Cory- Pearce R, Wheeldon D. Selection and procurement of hearts for transplantation. Br J Med 1994; 288: 1889-1991.

3. Wheeldon D. Early physiologic measurements in the donor heart. J Heart Lung Transplant 2004; 23: S247-S249.

4. Kaye MP. The registry of the International Society for Heart and Lung Transplantation: fourth official report – 1987. J Heart Transplant 1987; 6: 63-7.

5. Hosenpud JD, Bennett LE, Keck BM, Boucek MM, Novick RJ. The registry of the International Society for Heart and Lung Transplantation: seventeenth official report – 2000. J Heart Lung Transplant 2000; 19: 909-31.

6. Boyle Jr EM, Verrier ED, Spiess BD. Endothelial cell injury in cardiovascular surgery: the procoagulant response. Ann Thorac Surg 1996; 62: 1549-57.

7. Boyle Jr EM, Pohlman TH, Johnson MC, Verrier ED. Endothelial cell injury in cardiovascular surgery: the systemic inflammatory response. Ann Thorac Surg 1997; 63: 277-84.

8. Verrier ED. Activation of the endothelium in cardiac allografts. J Heart Lung Transplant 2004; 23: S229- S233.

9. Careaga G, Argüero R. Evaluation of the effect on acute rejection reaction and survival of the heart with the addition of dextran 60 to the conventional immunosuppressive therapy in an experimental model of heterotopic heart transplantation. Arch Med Res 2000; 31: 37-41.

10. Shumway NE, Lower RR. Special problems in transplantation of the heart. Ann N Y Acad Sci 1964; 120: 773m.

11. Argüero R, Careaga G, Castaño R, Garrido M, Sánchez O. Orthotopic heart transplantation for dilated cardiomyopathy with persistent left superior vena cava and atresia of the right superior vena cava. J Cardiovasc Surg 1997; 38: 403-5.

12. Conte JV. Chapter 54, Heart preservation. In: Franco KL, Verrier ED (Eds.). Advanced Therapy in Cardiac Surgery (2nd. Ed.). Londres: BC Decker Inc.; 2003, p. 560-9.

13. Wheeldon D, Sharples L, Wallwork J, English TAH. Donor heart preservation survey. J Heart Lung Transplant 1992; 11: 986-93.

14. Careaga G, Salazar D, Téllez S, Sánchez O, Borrayo G, Argüero R. Clinical impact of HTK cardioplegic solution on perioperative evolution in open heart surgery patients. Arch Med Res 2001; 32: 296-9.

15. Wieselthaler GM, Chevtchik O, Konetschny R, Moidi R, Mallinger R, Mares P, Greissmacher A, Grimm M, Wolner E, Laufer G. Improved graft function using a new myocardial preservation solution: Celsior, preliminary data from randomized prospective study. Transplant Proc 1999; 31: 2067-8.

16. Careaga G, Argüero R, Chávez-Negrete A, Valero G, Portilla E, García RM, Mendoza L, Angulo L, Miranda Y. Control of myocardial reperfusion injury with hypertonic-hyperosmotic solution in isolated rabbit heart. Eur Surg Res 1995; 27: 269-76.

17. Katori M, Tamaki T, Tanaka M, Konoueda Y, Yokota N, Hayashi T, Uchida Y, Takahashi Y, Kakita A, Kawamura A. Nitric oxide donor induces upregulation of stress proteins in cold ischemic rat hearts. Transplant Proc 1999; 31: 1022-3.

18. El Gamel A, Yonan NA, Grant S, Deiraniya AK, Rahman AN, Sarsam MA, Campbell CS. Orthotopic cardiac transplantation: a comparison of standard and bicaval Wythenshawe techniques. J Thorac Cardiovasc Surg 1995; 109: 721-30.

19. Large SR. Introduction and the challenge of brain death. J Heart Lung Transplant 2004; 23: S215- S216.

20. Taylor DO, Edwards LB, Boucek MM, Trulock EP, Keck BM, Hertz MI. The registry of the international society for heart and lung transplantation: twenty-first official adult heart transplant report-2004. J Heart Lung Transplant 2004; 23: 796-803.

21. Argüero R, Castaño R, Portilla E, Sánchez O, Molinar F. Primer caso de trasplante de corazón en México. Rev Med IMSS 1989; 27: 107-10.