An appraisal of neostigmine versus sugammadex for neuromuscular blockade reversal in patients with a prior heart transplant

Abstract

Based on the United Network for Organ Sharing (UNOS) database, 3 329 patients underwent heart transplantation in the United States in 2021. The development of new surgical techniques and monitoring methods, along with new immunosuppressant drugs, has significantly increased the survival of heart transplant patients [1,2]. Thus, the number of patients who require non-cardiac surgery after heart transplantation is undoubtedly increasing [1,3].Heart transplant recipients present unique perioperative challenges, given their changes in anatomy, physiology, pharmacokinetics, and pharmacodynamics [4]. Specifically, sympathetic and parasympathetic denervation of the heart leads

Orthotopic Heart Transplant Recipient Presenting with Sudden Onset Homonymous Hemianopia

“…However, in a retrospective analysis of 185 heart transplant recipient patients who underwent noncardiac operations, no significant differences in bradycardia and hypotension were observed in groups that received either a combination of neostigmine and antimuscarinic agents or sugammadex. 9 The interaction of immunosuppressants and perioperative drugs also requires special mention. Tacrolimus can lower seizure threshold, accentuate hypertension and diabetes, and can affect renal function.…”