Cardiac Transplantation - download pdf or read online

By Edwards N.M., Chen J.M., Mazzeo P.A.

Univ. of Wisconsin, Madison. Summarizes the day by day administration of transplant donors and recipients, protecting a variety of surgical thoughts, pathology, and immunosuppression. additionally discusses posttransplant administration, pediatric center transplantation, surgical choices, and mechanical circulatory advice. For physicians.

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Sample text

Although generally not the purview of the cardiac surgeon or transplant team, consent for organ donation should be requested by a professional trained in its acquisition. Multiple studies have demonstrated that the consent rate for organ donation at the request of an organ procurement organization (OPO) member is favored over a physician’s request (2). Therefore, we strongly encourage the early involvement of such OPO-designated individuals in the transplant process. Appropriate multiorgan donor assessment and management requires a careful balance of the solid organ transplant teams’ competing clinical agendas.

In addition, catheterization is often requested when there is a significant history of longstanding hypertension, cigarette smoking, insulin-dependent diabetes, cocaine use, or focal electrocardiographic or echocardiographic abnormalities. However, coronary angiography is frequently unavailable at small referring donor hospitals, and, in these cases, depending on the recipient’s acuity and the other concomitant donor risk factors, direct coronary palpation for atheromatous plaques by an experienced donor team may represent the best alternative assay of coronary disease.

If an organ becomes available and the recipient is not the highest candidate on the list, the transplant center needs to contact each transplant center in the sharing region to request that each center relinquish the organ to the requesting center on compassionate grounds. This should be confirmed in writing, signed by all program directors, and submitted to UNOS, preferably prior to the allocation of the organ. If this occurs in the middle of the night, a verbal agreement may be obtained and followed by written confirmation the next day.

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Cardiac Transplantation by Edwards N.M., Chen J.M., Mazzeo P.A.

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