The annual heart transplant rate is gradually increasing worldwide. A proportion of this patient population present for an elective or emergency surgery which may or may not be related to the transplanted heart. A MEDLINE search for heart transplant, anaesthesia, adult, paediatric and surgery was conducted to review anaesthetic management for heart transplant recipients. Anaesthesia and perioperative management are different in these cases. A thorough understanding of the physiology of denervated heart, post-transplant morbidities and pharmacology of immunosuppressants is essential for best perioperative management and improved post-operative outcome.
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http://dx.doi.org/10.4103/ija.IJA_390_17 | DOI Listing |
JACC Heart Fail
January 2025
Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. Electronic address:
Background: Growth differentiation factor (GDF)-15 is a pleiotropic cytokine that is associated with appetite-suppressing effects and weight loss in patients with malignancy.
Objectives: This study aims to investigate the relationships between GDF-15 levels, anorexia, cachexia, and clinical outcomes in patients with advanced heart failure with reduced ejection fraction (HFrEF).
Methods: In this observational, retrospective analysis, a total of 344 patients with advanced HFrEF (age 58 ± 10 years, 85% male, 67% NYHA functional class III), underwent clinical and echocardiographic examination, body composition evaluation by skinfolds and dual-energy x-ray absorptiometry, circulating metabolite assessment, Minnesota Living with Heart Failure Questionnaire, and right heart catheterization.
Turk Kardiyol Dern Ars
January 2025
Department of Cardiology, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Türkiye.
Objective: Although left ventricular hypertrophy frequently accompanies end-stage renal disease, heart failure (HF) with reduced ejection fraction (EF) is also observed in a subset of patients. In those patients kidney transplantation (KT) is generally avoided due to an increased risk of mortality in addition to the risks associated with HF. This prospective study was designed to follow patients with HF who were being prepared for KT.
View Article and Find Full Text PDFJ Clin Med
January 2025
Cardiac Surgery Unit, Spedali Civili, University of Brescia, 25124 Brescia, Italy.
Heart failure (HF) remains a significant public health issue, with heart transplantation (HT) being the gold standard treatment for end-stage HF. The increasing use of mechanical circulatory support, particularly left ventricular assist devices (LVADs), as a bridge to transplant (BTT), presents new perspectives for increasingly complex clinical scenarios. This study aimed to compare long-term clinical outcomes in patients in heart failure with reduced ejection fraction (HFrEF) receiving an LVAD as BTT to those undergoing direct-to-transplant (DTT) without mechanical support, focusing on survival and post-transplant complications.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Cardiology, University Hospital Zurich, 8091 Zurich, Switzerland.
Cardiac allograft vasculopathy (CAV) is a major prognosis-limiting factor in patients undergoing orthotopic heart transplantation (HT). Due to the diffuse involvement of the coronary tree, CAV lesions are often not amenable to percutaneous coronary intervention (PCI), leaving coronary artery bypass grafting (CABG) and retransplantation as primary revascularization options. : The latest guidelines from the International Society for Heart and Lung Transplantation (ISHLT) recognize CABG as a viable option but with a downgraded strength of recommendation.
View Article and Find Full Text PDFJ Clin Med
December 2024
Division of Cardiovascular Medicine, Tufts Medical Center, Boston, MA 02111, USA.
: Heart failure is the leading cause of hospital admission and mortality. Racial disparities have been demonstrated in various cardiovascular disorders; however, the data for in-hospital outcomes, complications, and procedural rates are limited. : Utilizing the National Inpatient Sample (NIS) database, this retrospective cohort study included adult patients admitted with a principal diagnosis of heart failure.
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