The experience of 70 heart transplants in a multidisciplinary medical care facility

Introduction. The total number of patients with chronic heart failure in Russia had reached 15 million by 2016, including 6 million of those with the end-stage heart failure. Currently, heart transplantation (HT) provides the only possible method of a definite treatment of the disease, which allows...

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Main Authors: M. Sh. Khubutiya, V. V. Sokolov, A. V. Redkoborodyy, I. A. Kozlov, V. Kh. Timerbaev, L. G. Khutsishvili, N. M. Bikbova, M. V. Parkhomenko, D. A. Kosolapov
Format: Article
Language:English
Published: N.V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare Department 2018-09-01
Series:Трансплантология (Москва)
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Online Access:https://www.jtransplantologiya.ru/jour/article/view/391
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author M. Sh. Khubutiya
V. V. Sokolov
A. V. Redkoborodyy
I. A. Kozlov
V. Kh. Timerbaev
L. G. Khutsishvili
N. M. Bikbova
M. V. Parkhomenko
D. A. Kosolapov
author_facet M. Sh. Khubutiya
V. V. Sokolov
A. V. Redkoborodyy
I. A. Kozlov
V. Kh. Timerbaev
L. G. Khutsishvili
N. M. Bikbova
M. V. Parkhomenko
D. A. Kosolapov
author_sort M. Sh. Khubutiya
collection DOAJ
description Introduction. The total number of patients with chronic heart failure in Russia had reached 15 million by 2016, including 6 million of those with the end-stage heart failure. Currently, heart transplantation (HT) provides the only possible method of a definite treatment of the disease, which allows a significant steady and long-term improvement of patient's quality of life.  The purpose of this article was to review the experience of heart transplantation in a multidisciplinary medical institution over an 8-year period.Material and methods. Since September 2009, more than 300 patients have been studied for the presence of indications for heart transplantation in the Department of Urgent Cardiology, Assisted Circulation and Heart Transplantation of the Sklifosovsky Research Institute for Emergency Medicine. Eighty of all the screened potential recipients were included in the waiting list, and by the end of 2017, heart transplantations had been performed in 70 of them; the mean waiting time for transplantation was 93 ± 79 days.Results. The graft ischemia time averaged 174 ± 28 minutes (97 to 250 minutes). The graft ischemia time was 187 ± 36 minutes with the biatrial technique and 169 ± 24 minutes with bicaval technique. That parameter made 184 ± 23 minutes for a distant organ retrieval, while for a local organ retrieval it was 155 ± 29 minutes. By the end of 2017, of 70 cardiac transplant recipients enrolled in the analyzed group, 31 patients (44%) had died, 12 of whom during their hospital stay (hospital mortality was 18%). The main cause of death was the multiple organ failure syndrome in the early postoperative period, and infectious complications in the later period.Conclusion. The advantage of establishing the organ transplantation center (particularly for heart transplantation) in a multidisciplinary medical care facility lies in reduced donor organ ischemia time and starting treatment of complications without delay. The number of infectious complications, as well as complications associated with acute cellular rejection and coronary artery disease of the transplanted heart can be reduced by creating a regional system ensuring the targeted work with post transplant patients.
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spelling doaj-art-de9ba3a7e391461d981cd01ec480a7742025-08-20T03:56:36ZengN.V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare DepartmentТрансплантология (Москва)2074-05062542-09092018-09-0110319720610.23873/2074-0506-2018-10-3-197-206378The experience of 70 heart transplants in a multidisciplinary medical care facilityM. Sh. Khubutiya0V. V. Sokolov1A. V. Redkoborodyy2I. A. Kozlov3V. Kh. Timerbaev4L. G. Khutsishvili5N. M. Bikbova6M. V. Parkhomenko7D. A. Kosolapov8N.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineIntroduction. The total number of patients with chronic heart failure in Russia had reached 15 million by 2016, including 6 million of those with the end-stage heart failure. Currently, heart transplantation (HT) provides the only possible method of a definite treatment of the disease, which allows a significant steady and long-term improvement of patient's quality of life.  The purpose of this article was to review the experience of heart transplantation in a multidisciplinary medical institution over an 8-year period.Material and methods. Since September 2009, more than 300 patients have been studied for the presence of indications for heart transplantation in the Department of Urgent Cardiology, Assisted Circulation and Heart Transplantation of the Sklifosovsky Research Institute for Emergency Medicine. Eighty of all the screened potential recipients were included in the waiting list, and by the end of 2017, heart transplantations had been performed in 70 of them; the mean waiting time for transplantation was 93 ± 79 days.Results. The graft ischemia time averaged 174 ± 28 minutes (97 to 250 minutes). The graft ischemia time was 187 ± 36 minutes with the biatrial technique and 169 ± 24 minutes with bicaval technique. That parameter made 184 ± 23 minutes for a distant organ retrieval, while for a local organ retrieval it was 155 ± 29 minutes. By the end of 2017, of 70 cardiac transplant recipients enrolled in the analyzed group, 31 patients (44%) had died, 12 of whom during their hospital stay (hospital mortality was 18%). The main cause of death was the multiple organ failure syndrome in the early postoperative period, and infectious complications in the later period.Conclusion. The advantage of establishing the organ transplantation center (particularly for heart transplantation) in a multidisciplinary medical care facility lies in reduced donor organ ischemia time and starting treatment of complications without delay. The number of infectious complications, as well as complications associated with acute cellular rejection and coronary artery disease of the transplanted heart can be reduced by creating a regional system ensuring the targeted work with post transplant patients.https://www.jtransplantologiya.ru/jour/article/view/391heart transplantationheart failureorgan donation
spellingShingle M. Sh. Khubutiya
V. V. Sokolov
A. V. Redkoborodyy
I. A. Kozlov
V. Kh. Timerbaev
L. G. Khutsishvili
N. M. Bikbova
M. V. Parkhomenko
D. A. Kosolapov
The experience of 70 heart transplants in a multidisciplinary medical care facility
Трансплантология (Москва)
heart transplantation
heart failure
organ donation
title The experience of 70 heart transplants in a multidisciplinary medical care facility
title_full The experience of 70 heart transplants in a multidisciplinary medical care facility
title_fullStr The experience of 70 heart transplants in a multidisciplinary medical care facility
title_full_unstemmed The experience of 70 heart transplants in a multidisciplinary medical care facility
title_short The experience of 70 heart transplants in a multidisciplinary medical care facility
title_sort experience of 70 heart transplants in a multidisciplinary medical care facility
topic heart transplantation
heart failure
organ donation
url https://www.jtransplantologiya.ru/jour/article/view/391
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