Anaesthesia for non-cardiac surgical procedures in patients after heart transplantation

Czech version

Authors: Jan Šoltés ^1,2; Hynek Říha ^1,2; Jan Bruthans ¹; Petr Kramář ²; Milan Ročeň ^2,3
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny 1. LF UK a VFN v Praze ¹; Klinika anesteziologie a resuscitace, Kardiocentrum IKEM, Praha ²; Klinika anesteziologie, resuscitace a intenzivní medicíny 2. LF UK a FN Motol, Praha ³
Published in: Čas. Lék. čes. 2022; 161: 139-143
Category: Review Article

Overview

Over the last 5 years, around 75 heart transplantations a year have been performed in the Czech Republic. According to these data and longer survival of these patients, it is obvious that non-cardiac surgical procedures in this particular group of patients are not rare. In the patients after heart transplantation, there is a significantly higher risk of undergoing elective and emergency surgical procedures due to various reasons. Appropriate anaesthesia and perioperative care are fundamentally affected by the knowledge of pathophysiological and pharmacological differences of transplanted heart. An equally important aspect is a lifetime immunosuppressive therapy in these patients.

Keywords:

infectious complications – heart transplantation – non-cardiac surgical procedure – anaesthesia after transplantation

Sources

Transplantační aktivita v ČR 2006–2020. Koordinační středisko transplantací, 2021. Dostupné na: https://kst.cz/wp-content/uploads/2021/02/Přehled-aktivity-v-ČR-od-roku-2006-2020.pdf
Swami AC, Kumar A, Rupal S, Lata S. Anaesthesia for non-cardiac surgery in a cardiac transplant recipient. Indian J Anaesth 2011; 55: 405–407.
Choudhury M. Post-cardiac transplant recipient: Implications for anaesthesia. Indian J Anaesth 2017; 61: 768–774.
Pirk J. Transplantace srdce. In: Pirk J (ed.). Kardiochirurgie. Maxdorf, Praha, 2019: 176–191.
First MR. Cadaveric organ procurement – an overview of two aspects: donor hospital networks, and minority donation. Transplant Proc 1997; 29: 70–72.
Goldraich LA, Leitão SAT, Scolari FL et al. A comprehensive and contemporary review on immunosuppression therapy for heart transplantation. Curr Pharm Des 2020; 26: 3351–3384.
Stover EP, Siegel LC. Physiology of the transplanted heart. Int Anesthesiol Clin 1995; 33: 11–20.
Thajudeen A, Stecker EC, Shehata M et al. Arrhythmias after heart transplantation: mechanisms and management. J Am Heart Assoc 2012; 1: e001461.
Parikh PB, Clerkin K, Mancini D, Kirtane AJ. Severe coronary artery spasm presenting as Prinzmetal's angina following cardiac transplantation. Cardiovasc Revasc Med 2018; 19: 13–15.
Eckhardt T, Pazderník M. Koronární nemoc srdečního štěpu v současnosti. Cor et Vasa 2021; 63: 73–78.
Blasco LM, Parameshwar J, Vuylsteke A. Anaesthesia for noncardiac surgery in the heart transplant recipient. Curr Opin Anesthesiol 2009; 22: 109–113.
Soar J, Böttiger BW, Carli P et al. European Resuscitation Council Guidelines 2021: Adult advanced life support. Resuscitation 2021; 161: 115–151.
Březina A. Anesteziologický postup při operaci u nemocných po transplantaci srdce. In: Pirk J, Málek I (eds.). Transplantace srdce. Karolinum, Praha, 2008.
Roest S, Hesselink A, Klimczak-Tomaniak D et al. Incidence of end-stage renal disease after heart transplantation and effect of its treatment on survival. ESC Heart Fail 2020; 7: 533–541.
Rizk J, Mehra MR. Anticoagulation management strategies in heart transplantation. Prog Cardiovasc Dis 2020; 63: 210–218.
Morgan‐Hughes NJ, Hood G. Anaesthesia for a patient with a cardiac transplant. BJA CEPD Rev 2002; 2(3): 74–78.
Brüssel T, Theissen JL, Vigfusson G et al. Hemodynamic and cardiodynamic effects of propofol and etomidate: negative inotropic properties of propofol. Anesth Analg 1989; 69: 35–40.
Alvarez-Alvarez RJ, Barge-Caballero E et al. Venous thromboembolism in heart transplant recipients: incidence, recurrence and predisposing factors. J Heart Lung Transplant 2015; 34: 167–174.
De Backer D, Vincent JL. Should we measure the central venous pressure to guide fluid management? Ten answers to 10 questions. Crit Care 2018; 22: 43.
Jabot J, Teboul JL, Richard C, Monnet X. Passive leg raising for predicting fluid responsiveness: importance of the postural change. Intensive Care Med 2009; 35: 85–90.
Monnet X, Bataille A, Magalhaes E et al. End-tidal carbon dioxide is better than arterial pressure for predicting volume responsiveness by the passive leg raising test. Intensive Care Med 2013; 39: 93–100.
Monnet X, Rienzo M, Osman D et al. Passive leg raising predicts fluid responsiveness in the critically ill. Crit Care Med 2006; 34: 1402–1407.
Degoute CS. Controlled hypotension: A guide to drug choice. Drugs 2007; 67: 1053–1076.
Chang DH, Youn J-C, Dilibero D et al. Heart transplant immunosuppression strategies at Cedars-Sinai Medical Center. Int J Heart Fail 2021; 3: 15–30.
Vasileiou I, Xanthos T, Koudouna E et al. Propofol: a review of its non-anaesthetic effects. Eur J Pharmacol 2009; 605: 1–8.
Menegaux F, Dorent R, Tabbi D et al. Biliary surgery after heart transplantation. Am J Surg 1998; 175: 320–321.
Kilic A, Sheer A, Shah AS et al. Outcomes of cholecystectomy in US heart transplant recipients. Ann Surg 2013; 258: 312–317.
Zywot A, Turner AL, Sesti J et al. Morbidity and mortality after general surgery in heart and lung transplant patients. Surgery Open Science 2020; 2: 140–146.
Abdalla M, Mancini D. Management of pregnancy in the post-cardiac transplant patient. Semin Perinatol 2014; 38: 318–325.
Wu DW, Wilt J, Restaino S. Pregnancy after thoracic organ transplantation. Semin Perinatol 2007; 31: 354–362.
Nishimura RA, Carabello BA, Faxon DP et al. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008; 52: 676–685.
Afolabi BB, Lesi FE, Merah NA. Regional versus general anaesthesia for caesarean section. Cochrane Database Syst Rev 2006; 4: CD004350.
Reynolds F, Seed PT. Anaesthesia for Caesarean section and neonatal acid-base status: a meta-analysis. Anaesthesia 2005; 60: 636–653.
Jain K, Bhardwaj N, Sharma A et al. A randomised comparison of the effects of low-dose spinal or general anaesthesia on umbilical cord blood gases during caesarean delivery of growth-restricted foetuses with impaired Doppler flow. Eur J Anaesthesiol 2013; 30: 9–15.
Early C, Stuckey L, Tischer S. Osteoporosis in the adult solid organ transplant population: Underlying mechanism and available treatment options. Osteoporos Int 2016; 27: 1425–1440.
Tessier JM, Sirkin M, Wolfe LG, Duane TM. Trauma after transplant: Hold the antibiotics please. Surg Infect (Larchmt) 2013; 14(2): 177–180.
Gupta PK, Hopkins PM. Regional anaesthesia for all? Br J Anaesth 2012; 109: 7–9.
Cook TM, Counsell D, Wildsmith JA. Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anesthetists. Br J Anaesth 2009; 102: 179–190.

Labels

Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental Hygienist

Úvodem

Současnost a perspektivy léčby obezity: Co již víme a co můžeme očekávat?

Současná bariatrická/metabolická chirurgie

Antiobesity drugs before and after bariatric surgery – how to make the best use of them

Nutriční péče o bariatrické pacienty

Recommendations for psychological assessment before bariatric surgery

Faecal microbiota transplantation in the treatment of recurrent intestinal Clostridioides difficile infection – a ten-year single-center experience

Bartter and Gitelman syndromes

Myocarditis as a manifestation of the disease COVID-19 and after vaccination against this disease

Thoracoscopic approach in the treatment of thoracic duct injuries – case reports and review of the literature

Use of unmanned aerial systems in the health care

Current issues of body donation for teaching and research purposes and their use in the Czech Republic