Background: Heart transplantations are ideal for most patients with end-stage heart failure refractory to medical treatment. The transplantation program at the Peruvian National Heart Institute started with a 10-year continuity in 2010.
Objective: To compare our 10-year heart transplantation experience results with international standards and reflect on our Transplant Program.
Methods: We studied 83 patients who underwent orthotopic heart transplantation at a single center between January 2010 and December 2019. The recipients' profiles and survival rates were analyzed according to sex and age group, ensuring the information's confidentiality.
Results: The recipients' mean age was 41.2 ± 17 years, 88% were adults, and 68.7% were male. The main indications for transplantation were idiopathic dilated cardiomyopathy. 85.5% of recipients were clinically categorized as INTERMACS profiles 1-3 before transplantation. There was a significant difference between sexes regarding the preoperative left ventricular ejection fraction and between age groups regarding the waiting time. The average ischemia time was 3.1 h, operating time was 6.1 h, cardiopulmonary bypass time was 3 h, and aortic cross-clamp time was 1.7 h. The principal early postoperative complications were hematological disorders and acute kidney failure. The principal late ones were kidney failure and severe anemia. The postoperative mortality was 15.9%, and the principal causes were infection and then acute rejection. The survival at 1, 5, and 10 years was 87.5%, 79.8%, and 79.8%, respectively. The survival results were not influenced by sex or age group.
Conclusion: Our patients' postoperative complications, mortality, and survival rates coincided with those reported by the ISHLT registry.
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http://dx.doi.org/10.1111/jocs.16429 | DOI Listing |
Sci Transl Med
January 2025
Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
Long-term, immunosuppression-free allograft survival has been induced in human and nonhuman primate (NHP) kidney recipients after nonmyeloablative conditioning and donor bone marrow transplantation (DBMT), resulting in transient mixed hematopoietic chimerism. However, the same strategy has consistently failed in NHP heart transplant recipients. Here, we investigated whether long-term heart allograft survival could be achieved by cotransplanting kidneys from the same donor.
View Article and Find Full Text PDFTransplantation
November 2024
Department of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Cardiac allograft vasculopathy (CAV) remains a significant challenge after heart transplantation, necessitating effective surveillance methods. This review centers around the role of coronary computed tomography angiography (CCTA) in CAV surveillance, given its unique capabilities to visualize and quantify CAV in comparison with other imaging modalities, including invasive coronary angiography and intravascular ultrasound. CCTA has shown good diagnostic performance for detecting and monitoring CAV, exemplified by a higher sensitivity and negative predictive value compared with invasive coronary angiography.
View Article and Find Full Text PDFAdv Sci (Weinh)
January 2025
Department of Cardiovascular Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330008, China.
Emerging research has highlighted the significant role of the gut microbiota in atherosclerosis (AS), with microbiota-targeted interventions offering promising therapeutic potential. A central component of this process is gut-derived metabolites, which play a crucial role in mediating the distal functioning of the microbiota. In this study, a comprehensive microbiome-metabolite analysis using fecal and serum samples from patients with atherosclerotic cardiovascular disease and volunteers with risk factors for coronary heart disease and culture histology is performed, and identified the core strain Bacteroides ovatus (B.
View Article and Find Full Text PDFFront Surg
January 2025
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
We report a case of a patient with dilated cardiomyopathy who experienced recurrent ventricular tachycardia (VT) and multiple defibrillations following CRT-D implantation. Due to worsening cardiac function, the patient required surgical implantation of a left ventricular assist device (LVAD) as a bridge to heart transplantation. During the procedure, we used the Ensite three-dimensional mapping system to perform activation and substrate mapping of the VT targets, followed by endocardial and epicardial cryoballoon ablation of clinical VT.
View Article and Find Full Text PDFPediatr Transplant
February 2025
Paediatric Intensive Care, Freeman Hospital, Newcastle upon Tyne, UK.
Background: Children with end-stage heart failure listed for cardiac transplantation may require mechanical ventilation and/or circulatory support whilst awaiting transplantation. A subgroup of these patients is unable to wean off mechanical ventilator support and undergo tracheostomy to enhance quality of life and allow de-escalation of intensive care. There is limited evidence of the use of tracheostomy associated with pediatric cardiac transplantation.
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