Summary
As survival and quality of life continue to improve for cardiac transplant recipients, the number of patients with functioning heart transplants who present for surgery continues to increase. The conditions for which surgery may be required, the specific problems relating to anaesthesia and the necessary measures which should be taken to ensure an uncomplicated clinical course are discussed. A clear understanding of the physiology and pharmacology of the denervated heart is essential for these patients to undergo safely anaesthesia and surgery.
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Shaw, I. W., Kirk, A. J. B., Conacher, I. D. Anaesthesia for patients with transplanted hearts undergoing non-cardiac surgery. British Journal of Anaesthesia 1991; 67: 772–778.
Melendez, J. A., Delphin, E., Lamb, J. Noncardiac surgery in heart transplant recipients in the cyclosporine era. Journal of Cardiothoracic and Vascular Anesthesia 1991; 5: 218–220.
Yee, J., Petsikas, D., Ricci, M. A., Guerraty, A. General surgical procedures after heart transplantation. Canadian Journal of Surgery 1990; 33: 185–188.
Kanter, S. F., Samuels, S.I. Anesthesia for major operations for patients who have transplanted hearts, A review of 29 cases. Anesthesiology 1977; 46: 65–68.
Lanza, R. P., Cooper, K. C., Cassidy, M. J. D., Barnard, C. N. Malignant neoplasms occurring after cardiac transplantation. Journal of the American Medical Association 1983; 249: 1746–1748.
Horgan, P. G., Fitzpatrick, M., Couse, N. F., Gorey, T. F., Fitzpatrick, J. M. Laparoscopy is less immunotraumatic than laparotomy. Minimally Invasive Therapy 1992; 1: 241–242.
Kent, P., Kerin, M. J., Wood, A. L., Fitzpatrick, J. M., Gorey, T. F. Laparoscopic cholecystectomy in cardiac transplant patients - lower threshold for surgery. Minimally Invasive Therapy 1993; 2: 181–183.
Toledo-Perreya, L. E. I. Complications of organ transplantation. New York: Marcel Dekker, Immunology Series 1987; 32: 313–363.
Mohanty, P. K., Thames, M. D., Arrowood, J. A., Sowers, J. R., McNamara, C., Szentpetery, S. Impairment of cardiopulmonary baroreceptor reflex after cardiac transplantation in humans. Circulation 1987; 75: 914–921.
Clark, D. A., Schroeder, J. S., Griepp, R. B., Stinson, E. B., Dong, E., Shumnay, N. E., Harrison, D. C. Cardiac transplantation in man — review of the first three years experience. American Journal of Medicine 1973; 54: 563–578.
Lower, R. R., Kontos, H. A., Kosek, J. C. Experiences in heart transplantation: technique physiology and rejection. American Journal of Cardiology 1968; 22: 766–771.
Pope, S. E., Stinson, E. B., Daughters, G. T., Schroeder, J. S., Ingels, N. B., Alderman E. L. Exercise response of the denervated heart in long-term cardiac transplant recipients. American Journal of Cardiology 1980; 46: 213–218.
Beck, W., Barnard, C. N., Schrire, V. Heart rate after cardiac transplantation. Circulation 1969; 40: 447–445.
Schroeder, J. S., Berke, D. K., Graham, A. F., Rider, A. K., Harrison, D. C. Arrhythmias after cardiac transplantation. American Journal of Cardiology. 1974; 33: 604–607.
Uretsky, B. F., Srinivas, M., Reddy, P. S., Rabin, B., Lee, A., Griffith, B. P., Hardesty, R. L., Trento, A., Bahnson, H. T. Development of coronary artery disease in cardiac transplant patients receiving immunosuppressive therapy with cyclosporine and prednisone. Circulation 1987; 4: 827–834.
Cooper, D. K., Becerra E. A., Novitzky, D., Ozinsky, J., Horak, A., Reichart, B. Surgery in patients with heart transplants — anaesthetic and operative considerations. South African Medical Journal. 1986; 70: 137–142.
Cheng, D: C. E. I., Ong, D. D. Anaesthesia for non-cardiac surgery in heart-transplanted patients. Canadian Journal of Anaesthesia. 1993; 40: 981–986.
Shenaq, S. A., Schultz, S., Noon, G. P., Seltzer, J. L., Stanley, T. H. Combined abdominal aortic aneurysm resection and cholecystectomy following prior heart transplantation. J. Cardiothorac. Vasc. Anesth. 1993; 7: 610–614.
Yusuf, S., Phil, D., Theodoropoulos, S., Mathias, C. J., Dhalla, N., Wittes, J., Mitchell, A., Yacoub, M. Increased sensitivity of the denervated transplanted human heart to isoprenaline both before and after beta-adrenergic blockade. Circulation 1987; 75: 696–704.
Tsarikis, A. G., Donald, D. E., Rutishauer, W. J. Cardiovascular responses to hypertension and hypotension in dogs with denervated hearts. Journal of Applied Physiology. 1969, 27: 817–821.
Salmon, S. E. Drugs and the immune system. In: Katzung, B. C. ed. Basic and Clinical Pharmacology. Connecticut: Appleton and Lange, 1987: 707–708.
De Paolis-Lutzo, M., Neill, A. L. Anesthetic considerations for the post cardiac transplant patient. American Association of Nurse Anaesthetists Journal. 1991; 59: 47–52.
Cirella, V. N., Pantuck, C. B., Lee, Y. J., Pantuck, E. J. Effects of cyclosporine on anesthetic action. Anesthesia and Analgesia. 1987; 66: 703–706.
Brown, B. R. Anesthesia and transplantation surgery: Contemporary anesthesia practice. Philadelphia: F. A. Davis Co. 1987: 10; 92–315.
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Lyons, J.B., Chambers, F.A., MacSullivan, R. et al. Anaesthesia for non-cardiac surgery in the post-cardiac transplant patient. I.J.M.S. 164, 132–135 (1995). https://doi.org/10.1007/BF02973279
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DOI: https://doi.org/10.1007/BF02973279