Premium
Elective versus emergency abdominal surgery following cardiac transplantation: a V ictorian state transplant service experience
Author(s) -
Kras Ashley L.,
Yo Shaun W.,
Marasco Silvana F.,
Wale Roger,
Warrier Satish K.
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12344
Subject(s) - medicine , elective surgery , surgery , abdominal surgery , transplantation , heart transplantation , cardiac surgery , immunosuppression , general surgery , emergency medicine
Background Heart transplant patients constitute a unique patient cohort with multiple risk factors predictive of poor surgical outcome. The A lfred H ospital offers the only heart transplant service in V ictoria, Australia. This article presents The A lfred H ospital's experience with outcomes of abdominal operations in the heart transplant patient population. Methods The statewide cardiothoracic registry was cross‐referenced with The A lfred H ospital's electronic hospital database to identify heart transplant patients who had undergone abdominal surgery from 2002 to N ovember 2012. Patients who met the inclusion criteria were evaluated in two groups: elective and emergency surgical settings. In the emergency group, risk factors recorded for poor surgical outcome were high‐dose immunosuppression therapy, diabetes and other conventional vascular risk factors. Outcome measures assessed in both groups were length of stay, readmission within 30 days and 1‐year mortality. Results Twelve patients were identified who underwent 13 abdominal operations. Eight were elective cases and five were emergent abdominal operations. The mean length of stay was shorter in the elective group than the emergency group (2.5 days versus 21.3 days). There was one readmission within 30 days, and no mortality at 1 year following elective surgery. In the emergency surgery group, two patients were readmitted within 30 days post‐operatively, and there were two deaths observed in this group. Conclusion The A lfred H ospital experience demonstrates that elective abdominal surgery following heart transplantation can be performed safely. Emergent surgery in this group of patients, however, is associated with poorer outcomes.