Open AccessA 6-YEAR EXPERIENCE OF HEART TRANSPLANTATION IN FEDERAL ALMAZOV NORTH-WEST MEDICAL RESEARCH CENTRE
Author(s) -
В. Шляхто,
Л. Гордеев,
А. Ми. Карпенко,
Vladimir A. Nikolaev,
С. Гневашев,
К. Гребенник,
И. П. Малая,
В. Наймушин,
Е. Рубинчик,
В. Сухова,
Iu Z Sitnikova,
М. Моисеева,
Б. Митрофанова,
А. А. Зверев,
A. Yu. Fedotov,
V.V. Sazonova,
С. С. Степанов
Publication year - 2017
Publication title -
vestnik transplantologii i iskusstvennyh organov
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.137
H-Index - 5
eISSN - 2412-6160
pISSN - 1995-1191
DOI - 10.15825/1995-1191-2016-4-33-42
Subject(s) - medicine , basiliximab , extracorporeal membrane oxygenation , heart transplantation , immunosuppression , thymoglobulin , surgery , survival rate , transplantation , mortality rate , bridge to transplantation , ventricular assist device , cardiology , heart failure , kidney transplantation
Aim . To estimate the results of 6-year experience of heart transplantation (HT) in Federal Almazov North-West Medical Research Centre. Methods. From 2010 to 2015 we have performed 65 HT. Mean age was 44.3 ± 14 years old (from 10 to 64 years old). We used biventricular assist device (BIVAD, Berlin Heart Excor) support in 7 heart transplant candidates before HT. 19 patients (29%) received thymoglobulin, whereas 46 patients (71%) had basiliximab to induce immunosuppression. Results. Extracorporeal membrane oxygenation machines were implanted in 5 patients (7.7%) after HT due to acute right ventricular failure. Suture annuloplasty (the Batista procedure) for tricuspid valve repair was carried out in 3 cases (4.6%). Venovenous hemodiafi ltration was used in 11 patients (16.9%). A total of 598 endomyocardial biopsies (EMB) were performed after HT. Evidence of cellular rejection (R1 and R2) was presented in 286 biopsies (48%). The 30-day in-hospital mortality rate was 3.1%. The 6-month survival rate after HT was 92%, 1-year – 91% and overall survival for the 6-year period of observation – 89.2%. Maximum observation period was 71 months. Conclusions. The 6-year experience of HT in our Center has shown a high level of survival. BIVAD Excor support can be effectively used as a «bridge» to HT. Prevention of graft loss due to acute rejection in heart transplant recipients can be achieved only through regular EMB monitoring. The rate of viral infection increased in 2 months after HT.