Review of Postoperative Care for Heart Transplant Recipients

J Cardiothorac Vasc Anesth. 2023 Jan;37(1):112-126. doi: 10.1053/j.jvca.2022.09.083. Epub 2022 Sep 19.

Abstract

The early postoperative management strategies after heart transplantation include optimizing the function of the denervated heart, correcting the causes of hemodynamic instability, and initiating and maintaining immunosuppressive therapy, allograft rejection surveillance, and prophylaxis against infections caused by immunosuppression. The course of postoperative support is influenced by the quality of allograft myocardial protection prior to implantation and reperfusion, donor-recipient heart size matching, surgical technique of orthotopic heart transplantation, and patient factors (eg, preoperative condition, immunologic compatibility, postoperative vasomotor tone, severity and reversibility of pulmonary vascular hypertension, pulmonary function, mediastinal blood loss, and end-organ perfusion). This review provides an overview of the early postoperative care of recipients and includes a brief description of the surgical techniques for orthotopic heart transplantation.

Keywords: immunosuppressive therapy; primary graft dysfunction; prophylaxis against infection; pulmonary vascular resistance; sinoatrial node dysfunction; vasoplegia.

Publication types

  • Review

MeSH terms

  • Graft Rejection* / prevention & control
  • Heart Transplantation* / adverse effects
  • Heart Transplantation* / methods
  • Humans
  • Postoperative Care / methods
  • Tissue Donors
  • Transplantation, Homologous