The Past, Present and Future of Heart Transplantation

Kim, In Cheol; Youn, Jong Chan; Kobashigawa, Jon A.

doi:10.4070/kcj.2018.0189

Cited by 110 publications

(114 citation statements)

References 97 publications

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“…However, the donor shortage is still a worldwide problem [ 4 ]. To overcome this difficulty, the concept of donation after circulatory death donors and the extended criteria donors have been used as mechanisms to increase the donor pool [ 5 , 6 ]. Currently, not only has the number of advanced heart failure patients risen, but the heart transplant candidates are more complex [ 5 , 7 ].…”

Section: Brief Historical Contextmentioning

confidence: 99%

Chagas Disease Infection Reactivation after Heart Transplant

Moreira

Cunha-Melo

2020

TropicalMed

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Chagas disease, caused by a Trypanosona cruzi infection, is one of the main causes of heart failure in Latin America. It was originally a health problem endemic to South America, predominantly affecting residents of poor rural areas. With globalization and increasing migratory flows from these areas to large cities, the immigration of T. cruzi chronically-infected people to developed, non-endemic countries has occurred. This issue has emerged as an important consideration for heart transplant professionals. Currently, Chagas patients with end-stage heart failure may need a heart transplantation (HTx). This implies that in post-transplant immunosuppression therapy to avoid rejection in the recipient, there is the possibility of T. cruzi infection reactivation, increasing the morbidity and mortality rates. The management of heart transplant recipients due to Chagas disease requires awareness for early recognition and parasitic treatment of T. cruzi infection reactivation. This issue poses challenges for heart transplant professionals, especially regarding the differential diagnosis between rejection and reactivation episodes. The aim of this review is to discuss the complexity of the Chagas disease reactivation phenomenon in patients submitted to HTx for end-stage chagasic cardiomyopathy.

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Section: Brief Historical Contextmentioning

confidence: 99%

Chagas Disease Infection Reactivation after Heart Transplant

Moreira

Cunha-Melo

2020

TropicalMed

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“…[18] Fungi can be involved in SSI after heart transplant. [23,24] This fact may be related to prolonged hospital stay [25,26] and to the immunosuppressive drugs prescribed to patients with transplant; [27,28] however, evidence supporting universal antifungal prophylaxis in patients undergoing heart and lung transplantation is still inconsistent. [29] With regard to the postoperative context, the studies obtained in the review characterized additional immunosuppression (use of corticosteroids, azathioprine and cyclosporins) as contextual stimulus.…”

Section: Discussionmentioning

confidence: 99%

Situation-specific theory of surgical site infection-related stimuli in patients undergoing heart transplantation

Lopes

Silva²,

Barbosa³

et al. 2019

JNEP

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Background and objective: Heart transplant is a life-saving treatment and currently is the definitive gold-standard in the treatment of refractory heart failure. Surgical site infection is a serious complication of heart transplantation. A nursing theory predicting consequences related to the management of risk factors for surgical site infection in patients undergoing heart transplantation can be useful to nursing practice. The objective of this study was to develop a situation-specific theory of surgical site infection-related stimuli in patients undergoing heart transplantation.Methods: It was adopted an integrative strategy to develop the theory. Multiple sources of knowledge were accessed. The Roy Adaptation Model was adopted as the foundation for the development of this situation-specific theory in a nursing perspective. A literature review on risk factors for surgical site infection in patients undergoing heart transplantation was conducted. By configuring those sources with practice expertise in a collaborative effort, risk factors for surgical site infection in patients undergoing heart transplantation were classified as contextual or residual stimuli, focal stimulus was defined, and seven theory propositions were developed.Results: Heart transplant surgery was considered as focal stimulus. The contextual stimuli were classified as preoperative, intraoperative, and postoperative contextual stimuli. The residual stimuli were classified as preoperative and intraoperative residual stimuli. No postoperative residual stimulus was identified. Ten theory propositions were created.Conclusions: The emerging theory can help nurses to prevent surgical site infections in patients undergoing heart transplantation. Further developments must be made in order to consider nurse-patient interactions during the prevention of surgical site infections.

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“…This denervation is responsible for numerous physiological phenomena usually observed in HTX patients, e. g. a high resting heart rate (HR) (approx. 95 bpm), a delayed increase in HR during exercise (chronotropic incompetence), delayed achievement of resting HR during the recovery phase following exercise, and significantly restricted HR variability [21][22][23].…”

Section: Alterations To the Cardiovascular Systemmentioning

confidence: 99%

“…Denervation gradually leads to an emptying of the catecholamine storage in the myocardium, meaning that the transplanted heart is then reliant on the stimulation of circulating catecholamines [21,23]. Overall, the catecholamine receptors display an increased sensitivity.…”

Section: Alterations To the Cardiovascular Systemmentioning

confidence: 99%

Exercise after Heart Transplantation: Typical Alterations, Diagnostics and Interventions

et al. 2020

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For the treatment of terminal heart failure, heart transplantation is considered to be the gold standard, leading to significantly improved quality of life and long-time survival. For heart transplant recipients, the development and maintenance of good functional performance and adequate exercise capacity is crucial for renewed participation and integration in self-determined live. In this respect, typical transplant-related alterations must be noted that play a significant role, leading to restrictions both centrally and peripherally. Before patients begin intensive and structured exercise training, a comprehensive diagnosis of their exercise capacity should take place in order to stratify the risks involved and to plan the training units accordingly. Particularly endurance sports and resistance exercises are recommended to counter the effects of the underlying disease and the immunosuppressive medication. The performance level achieved can vary considerably depending on their individual condition, from gentle activity through a non-competitive-level to intensive competitive sports. This paper includes an overview of the current literature on heart transplant recipients, their specific characteristics, as well as typical cardiovascular and musculoskeletal alterations. It also discusses suitable tools for measuring exercise capacity, recommendations for exercise training, required precautions and the performance level usually achieved.

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The Past, Present and Future of Heart Transplantation

Cited by 110 publications

References 97 publications

Chagas Disease Infection Reactivation after Heart Transplant

Chagas Disease Infection Reactivation after Heart Transplant

Situation-specific theory of surgical site infection-related stimuli in patients undergoing heart transplantation

Exercise after Heart Transplantation: Typical Alterations, Diagnostics and Interventions

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