THE INFLUENCE OF UNDERLYING PRETRANSPLANT DISEASE ON CARDIOTONIC AND VASOACTIVE THERAPY IN EARLY PERIOD AFTER HEART TRANSPLANTATION

Abstract

In our study there were 56 patients (54 men and 2 female) in age from 16 to 61 (41,2 ± 2,7) years. Severity of CHF in 36 (64,3%) patients were corresponded III class NYHA, in 20 (35,7%) patients – IV class. 12 (15,5%) patients was in 1B status of UNOS, 44 (60,8 %) patients – in II status. In all cases biatrial technique of OHT was used, total ischemic time was 107–330 (170 ± 11) min. All recipients were divided on two investigate groups. In the 1-st group (n = 31) recipients with pretransplant ischemic cardiomyopathy (ICM ) were included, in the 2-nd group (n = 25) – recipients with pretransplant dilated cardiomyopathy (DCM). There was no difference bet- ween groups in basic preoperative characteristic, ischemic transplant time, duration of cardiopulmonary bypass, type and severity of cardiac transplant dysfunction. Our study showed that ICM-group patients had higher level indexed systemic vascular resistance since 3 postoperative day, required more frequent use of dobutamine and isorbide dinitrate for systemic and pulmonary hemodynamic management in this category of heart recipients. Also ICM-group patients had more preferable systemic hemodynamic conditions for application of prostaglan- din E1 in more effective doses.

Keywords

• heart transplantation
• early postoperative period