Adult orthotopic heart transplantation: Early complications

John R. Spratt, Ziad Taimeh, Thenappan Thenappan, Ranjit John

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Heart transplantation carries significant risks for the recipient in the peri- and postoperative period. These include primary graft dysfunction (PGD), right ventricular (RV) failure, rejection, and infectious complications. Allograft ischemia-reperfusion and recipient pulmonary hypertension are common causes of PGD and RV failure. The use of inotropes, pulmonary vasodilators, and mechanical circulatory support (MCS) for the management of these issues is common. Early acute rejection is typically characterized by allograft dysfunction and is most commonly diagnosed by endomyocardial biopsy. Depending on the severity of presentation, management of acute rejection ranges from short-term corticosteroid therapy to MCS. Infectious complications are also a significant source of early morbidity and mortality in heart transplant recipients.

Original languageEnglish (US)
Title of host publicationCongestive Heart Failure and Cardiac Transplantation
Subtitle of host publicationClinical, Pathology, Imaging and Molecular Profiles
PublisherSpringer International Publishing
Pages493-504
Number of pages12
ISBN (Electronic)9783319445779
ISBN (Print)9783319445755
DOIs
StatePublished - Jun 1 2017

Keywords

  • Acute cellular rejection
  • Antibody-mediated rejection
  • Heart transplantation
  • Hyperacute rejection
  • Infection
  • Mechanical circulatory support
  • Primary graft dysfunction
  • Right ventricular failure
  • Size mismatch

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