Late Noncardiac Surgery in Heart Transplant Patients

Marzoa, R.; Crespo‐Leiro, María G.; Paniagua, María; Bendayán, Isaac Martínez; Rı́os, Ramón; Franco, Rocío Tovar; Rodríguez, José Antonio; Barge, Eduardo; Naya, C.; Gómez, Manuel; Cuenca, José; Juffé, Alberto; Castro‐Beiras, Alfonso

doi:10.1016/j.transproceed.2007.07.064

Cited by 15 publications

(11 citation statements)

References 7 publications

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“…This is consistent with studies performed in other surgical contexts that have concluded that elective surgery in patients receiving pre-operative anti-TNF therapy is safe. 2,3 However, further research is required to provide definitive evidence regarding the safety of anti-TNF drugs and other biologic medications in this setting.…”

Section: While Lin Et Al Adjusted For Several Clinically Relevant Varmentioning

confidence: 99%

Letter: pre‐operative anti‐TNF therapy in Crohn’s disease is not associated with increased complications following elective surgery

Istl

Yang

Fleshner

et al. 2019

Aliment Pharmacol Ther

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Section: While Lin Et Al Adjusted For Several Clinically Relevant Varmentioning

confidence: 99%

Letter: pre‐operative anti‐TNF therapy in Crohn’s disease is not associated with increased complications following elective surgery

Istl

Yang

Fleshner

et al. 2019

Aliment Pharmacol Ther

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“…Several studies have evaluated the outcomes of elective and emergent procedures in patients after solid organ transplant. [5][6][7][8]10 However, a study of emergent vs elective procedures in solid organ transplant recipients included only 7 orthopedic procedures. 10 The current study included 37 cases of emergent lower extremity fracture and found that complications such as…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9] In a study of solid organ transplant recipients undergoing any extramediastinal surgical procedure, the 2 most common complications were postsurgical infection and temporary renal dysfunction (6.9% and 2.6%, respectively). 10 In patients undergoing an emergent procedure, the mortality rate was significantly higher compared with the rate in those undergoing an elective procedure (16.6% vs 1%, respectively). 10 However, only 7 patients underwent an orthopedic procedure.…”

Section: Introductionmentioning

confidence: 89%

“…10 In patients undergoing an emergent procedure, the mortality rate was significantly higher compared with the rate in those undergoing an elective procedure (16.6% vs 1%, respectively). 10 However, only 7 patients underwent an orthopedic procedure. Another study found a complication rate of 7.1% after major orthopedic surgery in heart and lung transplant recipients, whereas the overall mortality rate for any procedure was 2%.…”

Section: Introductionmentioning

confidence: 89%

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Complicated Outcomes After Emergent Lower Extremity Surgery in Patients With Solid Organ Transplants

Reid¹,

Perdue²,

Goulet³

et al. 2016

Orthopedics

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The complications of emergent or urgent surgery in solid organ transplant recipients are unclear. The goal of this nonrandomized retrospective case study, conducted at a large public university teaching hospital, was to determine the following: (1) 90-day postsurgical complications in solid organ transplant recipients who undergo fracture surgery of the lower extremities; (2) 90-day and 1-year mortality rates for this cohort; (3) correlation of particular postsurgical complications with the 90-day or 1-year mortality rate; and (4) correlation of body mass index with the 90-day or 1-year mortality rate. Subjects included 36 solid organ transplant recipients who underwent surgical treatment for 37 emergent or urgent lower extremity fractures within 72 hours of presentation to the emergency department. Patients were followed for all medical and surgical complications for 90 days and for all-cause mortality for 1 year. Within 90 days of surgery, patients had complications that included acute renal failure (15, 40.5%), deep venous thrombosis (3, 8.1%), pulmonary embolus (2, 5.4%), pneumonia (7, 18.9%), superficial surgical site infection (3, 8.1%), and nonorthopedic sepsis (4, 10.8%). In addition, 3 (8.1%) and 5 (13.9%) patients died within 90 days and 1 year, respectively. Hospital readmission correlated with a higher 1-year mortality rate (odds ratio, 14.000; P=.016). Higher body mass index correlated with higher 90-day (odds ratio, 1.425; P=.035) and 1-year (odds ratio, 1.334; P=.033) mortality rates. Solid organ transplant recipients with lower extremity fracture have high 90-day and 1-year mortality rates and may have multiple complications within 90 days of treatment. [Orthopedics. 2016; 39(6):e1063-e1069.].

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“…1 With increasing life expectancy and accruing numbers of patients receiving heart transplants each year, the likelihood that some of these patients may develop noncardiac comorbidities requiring surgical intervention increases-currently with rates estimated at 15% to 47%. [2][3][4][5] The perioperative care of cardiac transplant patients can be challenging, as many of the commonly used preoperative risk assessments have limited applicability to a transplanted heart. For example, calculation of the Revised Cardiac Risk Index for a patient with a history of multivessel coronary artery disease and end-stage heart failure, who now has a normal functioning transplanted heart is possible, but not clinically relevant.…”

Section: Introductionmentioning

confidence: 99%

Perioperative Management of Cardiac Transplant Recipients Undergoing Noncardiac Surgery: Unique Challenges Created by Advancements in Care

Jurgens

Aquilante

Page

et al. 2017

Semin Cardiothorac Vasc Anesth

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Advancements in postcardiac transplant care have resulted in significant reductions in morbidity and increased life expectancy for cardiac transplant recipients. Consequently, many cardiac transplant recipients are living long enough to require subsequent noncardiac surgery. The perioperative care of heart transplant recipients presents a unique challenge as many of the common preoperative risk assessments do not apply to a transplanted heart, immunosuppressive medications have side effects and potential for drug-drug interactions, and the denervated heart results in an altered autonomic physiology and response to medications. Further adding to the challenge is that many of these noncardiac surgeries need to be performed urgently at nontransplant centers that may not be familiar with the care of these patients. This review aims to summarize the current data regarding preoperative assessment, perioperative immunosuppression management, intraoperative and anesthetic considerations, and outcomes of cardiac transplant recipients undergoing noncardiac surgery.

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Late Noncardiac Surgery in Heart Transplant Patients

Cited by 15 publications

References 7 publications

Letter: pre‐operative anti‐TNF therapy in Crohn’s disease is not associated with increased complications following elective surgery

Letter: pre‐operative anti‐TNF therapy in Crohn’s disease is not associated with increased complications following elective surgery

Complicated Outcomes After Emergent Lower Extremity Surgery in Patients With Solid Organ Transplants

Perioperative Management of Cardiac Transplant Recipients Undergoing Noncardiac Surgery: Unique Challenges Created by Advancements in Care

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