Author/Editor		Potočnik, Iztok; Hollan, Jiri
Title		Complications after heart transplantation: a case report
Type		članek
Source		In: 14th anesthesia symposium Alpe Adria; 2002 May 10-12; Pula. Zagreb: University school of medicine,
Publication year		2002
Volume		str. 53-4
Language		eng
Abstract		Heart transplantation is today the most aggressive, but also the most successful way to treat the end heart failure.1 Transplantation is indicated for the patients with an intense heart insufficiency (NYHA4, LVEF less than 20%), when all other surgical and medical alternatives are excluded.2 A lot of complications can appear in the perioperative period. Before the transplantation we have to consider all the patient's indications and contraindications for the transplantation.3 4 The most important absolute contraindications are: tixed pulmonary hypertensions 5 6 7 (as reflected by a calculated pulmonary vascular resistance above 6 Wood units, or a pulmonary arteriolar gradient greater than 15 mmHg.)8, active malignancy, active systemic infection, severe cerebral or carotid vascular disease not amenable to surgery, severe chronic obstructive pulmonary disease or severe chronic bronchitis, irreversible and severe hepatic or renal dysfunction (unless combined transplant is possible), unmanageable and/or severe psychiatric disease, active peptic ulcer disease, substance addictions, positive HIV test. Relative contraindications are: unusual weight loss, drug or alcohol abuse, cigarette smoking, advanced age (over 65 years), severe cachexy, morbid obesity, generalised atherosclerosis, diabetes mel litus in poor control, history of cancer. All candidates for transplantation should enter the program with a comprehensive series of tests conducted by a multidisciplinary team of specialists. The risks and benefits should be discussed with each patient.9 10 11.
Descriptors		HEART TRANSPLANTATION POSTOPERATIVE COMPLICATIONS HYPERTENSION, PULMONARY GASTROINTESTINAL HEMORRHAGE AGED