Abstract: Objective To summarize the surgical outcomes and clinical experience of surgical disease for patients having undergone orthotopic heart transplantation. Methods Five cardiac transplant recipients requiring surgical management due to other surgical diseases including acute cholecystitis in 2 patients, acute appendicitis, bilateral mammary hypertrophy and lung tumor in 1 patients, respectively. The mean age of the entire group at the time of reoperation was 44. 6 years (14-60 years) and the average time of operative procedures after transplant was 16. 4 months (4-37 months). Four patients were treated with t riple immunosuppression, including cyclosporine A (CsA ) or tacroimus, mycophenolate mofetil and corticosteroids, respect ively. One patient received double-therapy of CsA and mycophenolate mofetil withearly withdrawal of corticosteroids. All the acute cholecystitis and appendicitis patients underwent open cholecystectomy and appendectomy emergently. Reduction mammaplasty was performed on the bilateral mammary hypert rophy patients. For the lung tumor patient, right upper lobectomy and nodes excision were undertaken radically after the sample proved to be malignancy by the thoracoscopy. Closely surveillance at concentration of CsA or FK506 was performed continueously in o rder to adjust the effect ive blood concentration in a steady way by which acute rejection can be avoided. The pathways which pathogen organisms invading the human body were controlled strictly as well as intension on ant i-infection treatment during perioperative period. Results Four patients discharged to home within 2 weeks. Only one patient needed further treatment in Digestive Department after emergent cholecystectomy due to gastric retention. And shewas discharged after 66 days. No acute reject ions or operative complications such as severe infection or bleeding were found during the perioperative period. The average length of stay was 21. 3 days (8-66 days). During the fo llow -up from 1month to 13months, there was no relapse or allograft disfunction performed on any patients. All of them enjoy quality lives. Conclusions More attention should be paid to regular follow -up after transplantation, by which the emergent surgical diseases can be diagnosed and treated earlier and more effectively. Cardiac transplant recipients who subsequently require surgical intervention do quite well overall. Most of them can obtain excellent surgical outcomes.
Citation： LI Jun,WANG Chunsheng,CHEN Hao,LAI Hao,YANG Shoug uo,ZHU Sh ij ie.. Surgical Procedures in Five Heart Transplant Patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2008, 15(1): 17-20. doi: Copy