Our data showed that intra-aortic balloon pump support may be successfully and safely used in the acute decompensated dilated cardiomyopathy patients, as an urgent measure of cardiac support, to stabilize the patient and maintain organ perfusion until transplant is available, VAD is placed or patient is weaned from IABP.
The purpose of this study was to evaluate sensitisation, occurring because of bridging with VAD, and development of rejection episodes after transplantation in selected groups of patients using triple drug immunosuppression, without induction or desensitisation therapy. Sensitisation using standard complement dependent cytotoxicity was tested in 16 patients awaiting cardiac transplantation before VAD placement, one month post-implantation and on a six-monthly basis later on. Long-term (955+/-998 days) post-transplant course of six transplanted post-VAD patients was compared with 19 non-bridged recipients (follow-up time 1425+/-1273 days) of the same age. One-third of VAD recipients had developed anti-HLA antibodies one month post-implantation; 4/16 patients were sensitised six months after implantation. No de novo sensitisation development was revealed in VAD group post-transplantation. All sensitised patients independent of VAD placement underwent graft rejection episodes. Only 1 of 6 VAD recipient was treated because of grade 2R rejection, compared to 6/19 in the non-bridged group, P=0.63. None of the patients had failed because of early graft rejection. In conclusion, VAD devices used in our centre cause low level risk for anti-HLA antibodies development. There were no differences in survival due to immunologic reasons between VAD bridged and non-bridged patients.
Citomegalovirusinis (CMV) virðkinimo trakto paþeidimas yra vienas ið klinikiniø infekcijos poreiðkiø pacientams po organø persodinimo. Gastrointestininës CMV formos diagnostika daþnai yra sudëtinga, o padariniai sunkûs. Pristatomas CMV ligos po ðirdies persodinimo atvejis, diagnostikos ypatumai ir gydymo rekomendacijos.
Pagrindiniai þodþiai: ðirdies persodinimas, citomegalo viruso infekcijaCytomegalovirus infection can cause lesions of different organs, including gastrointestinal tract. In transplant patients, CMV infection can be associated with severe consequences. This case details the clinical and diagnostic features of gastrointestinal CMV disease in a patient after heart transplantation, in which treatment resulted in a complete resolution of the symptoms.
A p þ v a l g o sVilniaus universiteto Ðirdies chirurgijos centre nuo 1987 metø atliekamos ðirdies transplantacijos operacijos. Per ðá laikotarpá recipientø sàraðuose buvo áraðyti 268 pacientai, atliktos 47 ðirdies transplantacijos. Ðiuolaikiniai medikamentinio, elektrofiziologinio ir chirurginio gydymo metodai gerokai padidino pacientø, laukianèiø ðirdies transplantacijos, iðgyvenimà, taèiau ðirdies transplantacija tebëra veiksmingiausias gydymo metodas terminalinëmis ðirdies nepakankamumo stadijomis. Pastaraisiais metais Vilniaus universiteto Ðirdies chirurgijos klinikoje ádiegti nauji diagnostikos metodai (spiroergometrija, NT-pro-BNP nustatymas) leidþia praktiðkai pritaikyti ðiuolaikinius atrankos kriterijus. Ðiame straipsnyje remiantis literatûros apþvalga ávardyti pagrindiniai recipientø atrankos ðirdies transplantacijai kriterijai, taikomi ir Vilniaus universiteto Ðirdies chirurgijos centre.
Pagrindiniai þodþiai: ðirdies nepakankamumas, recipientø atranka, transplantacijaHeart transplantations at Vilnius University Heart Surgery Centre have been performed since 1987. During all this period, 268 patients were included into the recipients' list and 47 heart transplantations were performed. The current medical, electrophysiological and surgical methods have obviously increased the survival of patients who are waiting for heart transplantation.
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