Short- and long-term results of open heart surgery in patients with abdominal solid organ transplant☆

Ōno, Minoru; Wolf, Randall K.; Angouras, Dimitrios C.; Brown, David A.; Goldstein, Andrew H.; Michler, Robert E.

doi:10.1016/s1010-7940(02)00060-x

Cited by 43 publications

(50 citation statements)

References 13 publications

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“…In our series, there was no perioperative mortality in either of the groups. This is in contrast to other studies where the perioperative mortality varied from 1.4 [2], 2 [23], 3 [16], 5 [15] and 8.8 [21] to 14% [1]. However, Prabhakar's group [14] has also reported no early mortality.…”

Section: Original Articlecontrasting

confidence: 80%

“…Some of the groups have restricted the study to only valves [17] or only CABG [18,19]. However, most groups have studied the combined population of CABG and valve patients [13][14][15][16][20][21][22][23]. In our series, there was no perioperative mortality in either of the groups.…”

Section: Original Articlementioning

confidence: 92%

“…Most reports have concentrated on renal transplant patients [13], while others have considered only liver transplants [14] and some have included pancreatic transplants as well [2,15]. Our study investigated both liver and kidney transplant patients.…”

Section: Original Articlementioning

confidence: 99%

See 2 more Smart Citations

Cardiac Surgical Outcomes in Abdominal Solid Organ (Renal and Hepatic) Transplant Recipients: A Case Matched Study

Sharma

Hawley

Griffin

et al. 2011

Heart, Lung and Circulation

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OBJECTIVES: This study aims to investigate the outcomes of cardiac surgery in patients with abdominal solid organ transplants and to compare them with the case-matched population undergoing cardiac surgery. METHODS:Data from all transplant recipients abdominal solid organ transplant (ASOT) N = 36 (30 renal and 6 hepatic) who underwent cardiac surgery in a single centre during the period from January 1997 to December 2010 were collected from hospital transplant registries and the cardiac database. The transplant recipients were case matched (CM) with 104 patients in terms of the variables of age, sex and the type of cardiac surgery. Follow-up data were obtained from medical records and by a set of questionnaire through telephonic interviews.RESULTS: Follow-up times were 4.5 ± 3.2 and 3.9 ± 3.2 years in the transplant and CM groups, respectively. Follow-up in the transplant group was 100%. There was no 30-day mortality in the transplant group. Thirty-day combined major morbidities were 9% in the matched group vs 11% in the transplant patients (P = 0.6). Median length of stay was 6 days (inter-quartile range, IQR 5.9) for ASOT vs 5 days (IQR 4.6) for CM (P < 0.01). New dialysis was 8.3% in transplant patients compared with 0.96% in the matched population, while infection was 16.66 vs 0.42% in the CM cohort. There was no allograft failure/dysfunction at the time of death or latest follow-up. Late deaths were 8 of 36 (22%) in ASOT vs 6 of 104 (6%) in CM. Infection (63%) was the most frequent major cause of death in transplant patients. One-, 2-, 5-and 10-year survivals for ASOT vs CM were 94, 88, 80, 59 vs 99, 99, 91, 85%, respectively. Multivariate predictors of mortality were increasing age (hazard ratio, HR 1.1, 95% confidence interval, CI 1.04-1.18; P = 0.003) and solid organ transplantation (HR 3.44, CI 1.19-9.98; P = 0.023).CONCLUSIONS: Cardiac surgery can be performed in patients with abdominal solid organ tranpslant recipients with acceptable early morbidity and mortality. However, long-term survival in transplant patients is poor. Infection remains the most common cause of death.

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Section: Original Articlecontrasting

confidence: 80%

Section: Original Articlementioning

confidence: 92%

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Cardiac Surgical Outcomes in Abdominal Solid Organ (Renal and Hepatic) Transplant Recipients: A Case Matched Study

Sharma

Hawley

Griffin

et al. 2011

Heart, Lung and Circulation

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“…I mprovements in the immunosuppressive regimen, surgical techniques, and postoperative management have resulted not only in the remarkable success of solid organ transplantation with an increasing pool of older patients but also in an increasing number of patients who require elective or emergency transplant and nontransplant-related surgical procedures (1)(2)(3). With the aging of the surviving transplant population, the number of recipients who develop cardiovascular disease has risen.…”

mentioning

confidence: 99%

Heart Valve Operations in Solid Organ Recipients: An 18-Year Single-Center Experience

Musci

Yankah²,

Klose³

et al. 2007

Transplantation

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“…This was in accordance with the recommendation of Ono et al, who believe that a bioprosthesis is not preferred in young patients because the young are likely to live long. 9 Therefore, the chance of reoperation after bioprosthetic valve replacement in young patients is much higher than in older ones. Having considered the specifi c situation of our young patient who was a candidate for liver transplantation 2 months after the cardiac surgery and the need for immunosuppressants after the transplantation, we decided that using a bioprosthetic valve might endanger the patient in the future by exposing him to the possibility of another major operation for a second valve replacement.…”

Section: Discussionmentioning

confidence: 99%

Aortic valve replacement in a patient with liver cirrhosis and coagulopathy

Nemati

Astaneh

Zamirian

2008

Gen Thorac Cardiovasc Surg

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Open heart surgery in patients with end-stage liver disease is accompanied by various complications. Coagulopathy resulting from liver failure tends to cause uncontrollable hemorrhage. Severe aortic insufficiency has moderate to severe risk for liver transplantation. It can lead to heart failure, liver congestion, and finally rejection of the transplanted liver. Aortic valve replacement in patients diagnosed as having cirrhosis has a significant risk of mortality because of the above-mentioned complications. We present a patient with liver cirrhosis and severe aortic insufficiency who had thrombocytopenia and severe coagulopathy. Aortic valve replacement was performed successfully using cardiopulmonary bypass before the liver transplantation. Hemostasis management was done effectively perioperation. The postoperative course was uneventful, and the patient was discharged after 10 days. Liver transplantation was performed successfully 2 months later.

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Short- and long-term results of open heart surgery in patients with abdominal solid organ transplant☆

Cited by 43 publications

References 13 publications

Cardiac Surgical Outcomes in Abdominal Solid Organ (Renal and Hepatic) Transplant Recipients: A Case Matched Study

Cardiac Surgical Outcomes in Abdominal Solid Organ (Renal and Hepatic) Transplant Recipients: A Case Matched Study

Heart Valve Operations in Solid Organ Recipients: An 18-Year Single-Center Experience

Aortic valve replacement in a patient with liver cirrhosis and coagulopathy

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