Savaş Bozbaş Şerife, Ulubay Gaye, Öner Eyüboğlu Füsun, Sezgin Atilla, Haberal Mehmet
From the Department of Pulmonary Disease, Baskent University Faculty of Medicine, Ankara, Turkey 06490.
Exp Clin Transplant. 2015 Nov;13 Suppl 3:140-3. doi: 10.6002/ect.tdtd2015.P76.
Heart transplant is the best treatment for end-stage heart failure. Respiratory insufficiency after heart transplant is a potentially serious complication. Pulmonary complications, pulmonary hypertension, allograft failure or rejection, and structural heart defects in the donor heart are among the causes of hypoxemia after transplant. In this study, we evaluated the prevalence of hypoxemia and respiratory insufficiency in patients with orthotopic heart transplant during the early postoperative period.
We retrospectively evaluated the medical records of 45 patients who had received orthotopic heart transplant at our center. Clinical and demographic variables and laboratory data were noted. Oxygen saturation values from patients in the first week and the first month after transplant were analyzed. We also documented the cause of respiratory insufficiency and the type of treatment.
Mean age was 35.3 ± 15.3 years (range, 12-61 y), with males comprising 32 of 45 patients (71.1%). Two patients had mild chronic obstructive pulmonary disease and 1 had asthma. Twenty-five patients (55.6%) had a history of smoking. Respiratory insufficiency was noted in 9 patients (20%) during the first postoperative week. Regarding cause, 5 of these patients (11.1%) had pleural effusion, 2 (4.4%) had atelectasis, 1 (2.2%) had pneumonia, and 1 (2.2%) had acute renal failure. Therapies administered to patients with respiratory insufficiency were as follows: 5 patients had oxygen therapy with nasal canula/mask, 3 patients had continuous positive airway pressure, and 1 patient had mechanical ventilation. One month after transplant, 2 patients (4.4%) had respiratory insufficiency 1 (2.2%) due to pleural effusion and 1 (2.2%) due to atelectasis.
Respiratory insufficiency is a common complication in the first week after orthotopic heart transplant. Identification of the underlying cause is an important indicator for therapy. With appropriate care, respiratory insufficiency can be treated successfully.
心脏移植是终末期心力衰竭的最佳治疗方法。心脏移植后呼吸功能不全是一种潜在的严重并发症。肺部并发症、肺动脉高压、移植心脏功能衰竭或排斥反应以及供体心脏的结构性心脏缺陷是移植后低氧血症的原因。在本研究中，我们评估了原位心脏移植患者术后早期低氧血症和呼吸功能不全的发生率。
我们回顾性评估了在我们中心接受原位心脏移植的45例患者的病历。记录临床和人口统计学变量以及实验室数据。分析了移植后第一周和第一个月患者的血氧饱和度值。我们还记录了呼吸功能不全的原因和治疗类型。
平均年龄为35.3±15.3岁（范围12 - 61岁），45例患者中有32例男性（71.1%）。2例患者患有轻度慢性阻塞性肺疾病，1例患有哮喘。25例患者（55.6%）有吸烟史。术后第一周有9例患者（20%）出现呼吸功能不全。关于原因，这些患者中有5例（11.1%）有胸腔积液，2例（4.4%）有肺不张，1例（2.
