Associated factors with survivals in patients undergoing orthotopic heart transplant using retrograde blood microcardioplegia

Abstract

Fatores associados à sobrevida em pacientes submetidos a transplante cardíaco utilizando microcardioplegia sanguínea retrógrada Associated factors with survivals in patients undergoing orthotopic heart transplant using retrograde blood microcardioplegia Abstract Background: Several techniques and cardioplegic solutions have been used for heart preservation during transplant procedures. Unfortunately, there is a lack of ideal method for myocardial preservation in the clinical practice. The use of retrograde cardioplegia provides continuous infusion of cardioplegic solution during the graft implantation. This strategy may provide better initial recovery of the graft. The objective of this study is to describe the experience of a single center where all patients received the same solution for organ preservation and were subjected to continuous retrograde blood microcardioplegia during implantation of the graft and to evaluate factors associated to early and late mortality with this technique.Methods: This is a retrospective, observational and descriptive study of a single center.Results: During the study period were performed 35 heart transplants. Fifteen (42.9%) patients were in cardiogenic shock. The probability of survival was 74.8±7.8%, 60.4±11.3% and 15.1±13.4% at 1 year, 5 years and 10 years of follow-up, respectively. The median survival time was 96.6 months.Conclusion: The use of myocardial protection with retrograde cardioplegic solution may reduce the risks associated morbidity due to cold ischemia time during the heart transplant, and we suggest that this benefit may be even greater in cases of cold ischemia time longer ensuring protection to the myocardium.Descriptors: Heart transplantation. Transplantation. Heart arrest, induced. Myocardium. Follow-up studies. ResumoIntrodução: Uma grande variedade de técnicas e soluções é utilizada na preservação do coração durante o transplante, o que demonstra a falta de método ideal na prática clínica. A 348Lavagnoli CFR, et al. -Associated factors with survivals in patients undergoing orthotopic heart transplant using retrograde blood microcardioplegia Bras Cir Cardiovasc 2012;27(3):347-54 INTRODUCTION A variety of techniques and solutions are used in the preservation of the heart during transplantation, demonstrating the lack of ideal method in clinical practice [1]. RevIn the present day, where the number of donors is not enough, in addition to the increase of high-risk recipients on the waiting list, every effort should be made towards better organ preservation. A better organ preservation leads to lower graft dysfunction and promotes better late outcomes after transplantation [2,3].The use of retrograde blood cardioplegia has been described in several studies in the literature. There is no consensus whether this strategy promotes adequate myocardial protection [4]. Its use for the administration of blood cardioplegia during implantation is frequently reported in the literature. This strategy of cardioplegia administration allows for continuous perfusion o...

Profile of Heart Donors from the Human Valve Bank of the Santa Casa de Misericórdia de Curitiba

“…However, for human tissue donations, donors that had evolved into CRA are accepted. The number of corneal tissue donations has increased from donors who were given the diagnosis of BD and had evolved to CRA [ 11 , 12 ] . In the analysis of the profile of BVCH donors, it was observed that there is less family refusal in situations in which the potential donor was in CRA.…”

Addition of long-distance heart procurement promotes changes in heart transplant recipient waiting list status

“…There are a great range of myocardial protection solutions on the market and modes of infusion in heart transplant [ 10 - 12 ] . However, there is controversy on the superiority of one solution over the others.…”